title: Comparison of the surgical treatment strategies for Siewert type II squamous cell carcinoma in the same area as esophagogastric junction carcinoma: data from a single Japanese high-volume cancer center.
abstract: OBJECTIVE
  Siewert type II esophagogastric junction adenocarcinoma (ADC) and squamous cell carcinoma (SCC) existing in the same area have distinct clinicopathological characteristics. The objective of this study was to examine differences in the surgical treatment and survival data, according to the histological subtype, in a single high-volume cancer center.
  
  
  METHODS
  We retrospectively examined data from a total of 123 patients. Seventy-two patients with Siewert type II ADC and 51 patients with SCC in the same area.
  
  
  RESULTS
  In terms of the clinicopathological factors, the SCC patients had more advanced stage disease and thoracotomy was more frequently performed than in the ADC patients. The 5-year overall survival (OS) rates did not differ significantly between SCC and ADC, regardless of whether or not mediastinal, splenic hilum and para-aortic lymph node dissection was performed. Based on the calculated index for the frequency of nodal metastasis and the five-year OS rate for involvement at each level, only node nos. 1, 2, 3 and 7 had a high index (>5) in both groups. The multivariate Cox regression analysis showed that only age (<65), the pN category and residual tumor classification were independently associated with the outcome.
  
  
  CONCLUSIONS
  Differences in the histological type of esophagogastric junction cancer were not independent prognostic factors for survival, and there appears to be a benefit to dissecting the number 1, 2, 3 and 7 lymph nodes.
authors.affiliation: Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicyo, Chuo-ku, Niigata, 951-8566, Japan, yabu@niigata-cc.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yabusaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nashimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsuki
authors.forename: Masaki
authors.initials: M
authors.lastname: Aizawa
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors