title: Correlation between endoscopic macroscopic type and invasion depth for early esophagogastric junction adenocarcinomas.
abstract: BACKGROUND
  Although correlations between endoscopic macroscopic type and tumor depth have been reported for superficial esophageal squamous cell carcinoma and early gastric and early colorectal adenocarcinomas, there is no published study investigating the correlation between endoscopic macroscopic type and invasion depth for mucosal (M) and submucosal (SM) adenocarcinomas located at the esophagogastric junction (EGJ). We decided to analyze, therefore, the relationship between endoscopic macroscopic type and tumor depth for such cancers.
  
  
  METHODS
  We retrospectively reviewed 73 early EGJ adenocarcinomas (M/SM = 33/40; differentiated/undifferentiated type = 70/3) in 73 consecutive patients treated endoscopically and/or surgically between January 2000 and December 2008. The mean age of the patients was 63.9 years (range 37-85 years) and the male/female ratio was 62:11. EGJ adenocarcinoma was defined as junctional carcinoma (type II) according to the Siewert classification.
  
  
  RESULTS
  We found polypoid type lesions (0-I) in 14 patients, non-polypoid type without mixed type (0-IIa, 0-IIb, or 0-IIc) in 39, and mixed type (0-IIa + IIc or 0-IIc + IIa) in 20 patients. Non-polypoid type without mixed type (31%; 12/39) lesions had a significantly lower risk for SM invasion compared to polypoid type (79%; 11/14; p < 0.01) and mixed type (85%; 17/20; p < 0.01) lesions. In polypoid type lesions, the risk of SM invasion was significantly lower for the pedunculated subtype (0-Ip) than for the sessile subtype (0-Is) lesions (0%; 0/2 vs. 92%; 11/12; p < 0.05). M lesions (mean size 14.5 ± 7.5 mm) were significantly smaller than SM lesions (24.5 ± 7.7 mm; p < 0.01).
  
  
  CONCLUSIONS
  Determination of endoscopic macroscopic type may be useful in accurately diagnosing early EGJ adenocarcinoma invasion depth.
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, 104-0045, Japan. ioda@ncc.go.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Oda
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Abe
authors.forename: Chika
authors.initials: C
authors.lastname: Kusano
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Suzuki
authors.forename: Satoru
authors.initials: S
authors.lastname: Nonaka
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yoshinaga
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Shimoda
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000473:pathology*; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*