title: Impact of esophageal invasion on clinicopathological characteristics and long-term outcome of adenocarcinoma of the subcardia.
abstract: OBJECTIVE
  A different classification system was used in the 7th edition of the TNM classification for adenocarcinoma of the subcardia either with or without esophageal invasion. The aim of this study was to clarify the clinicopathological and survival impact of esophageal invasion.
  
  
  METHODS
  The present study included 351 patients who underwent gastrectomy for adenocarcinoma located within 5 cm of the esophagogastric junction. The clinicopathological characteristics and survival curves were compared between patients with esophageal invasion [E (+) group, n = 125] and without esophageal invasion [E (-) group, n = 226].
  
  
  RESULTS
  Patients in the E (+) group had more advanced disease. The 5-year survival rate following macroscopic curative resection was significantly better in the E (-) group (80.8%) than in the E (+) (48.7%, P < 0.001), even after stratification by the pathological stage and nodal status. Multivariate analysis identified esophageal invasion (hazard ratio; 3.323, 95% confidential interval; 1.815-6.082) as one of the independent prognostic factors.
  
  
  CONCLUSIONS
  Esophageal invasion affected the clinicopathological characteristics and long-term outcome of patients. Further study is necessary to clarify whether patients with esophageal invasion should be classified using the system for esophageal cancer or by another method.
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan. m.tokunaga@scchr.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Tokunaga
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanizawa
authors.forename: Etsuro
authors.initials: E
authors.lastname: Bando
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kawamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
authors.forename: Masanori
authors.initials: M
authors.lastname: Terashima
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome