title: Is gastric tube reconstruction the optimal surgical procedure for Siewert type II esophagogastric junction carcinoma?
abstract: OBJECTIVE
  To evaluate the potential risk of gastric tube reconstruction for Siewert type II esophagogastric junction carcinoma.
  
  
  METHODS
  We retrospectively analyzed clinicopathological and survival data of 41 patients who had undergone total gastrectomy for Siewert type II carcinoma, focusing on lymph node metastasis around the middle to lower greater curvature or parapyloric area.
  
  
  RESULTS
  Histological examination showed involvement of at least one lymph node in six patients (14%). Multivariate Cox proportional hazard regression analysis of seven clinicopathological variables showed that lymph node metastasis around the middle to lower greater curvature, or parapyloric area was the only significant independent unfavorable factor (odds ratio=6.62; 95% confidence interval=1.27-41.1; p=0.03) for survival. We identified no significant predictors of lymph node metastasis in analyzed patients.
  
  
  CONCLUSIONS
  From an oncological point of view, we do not recommend routine gastric tube reconstruction for Siewert type II carcinoma.
authors: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe, Saitama 350-8550, Japan. mfukuchi@saitama-med.ac.jp.
authors: Minoru
authors: M
authors: Fukuchi
authors: Erito
authors: E
authors: Mochiki
authors: Okihide
authors: O
authors: Suzuki
authors: Toru
authors: T
authors: Ishiguro
authors: Jun
authors: J
authors: Sobajima
authors: Kana
authors: K
authors: Saito
authors: Hiroshi
authors: H
authors: Naitoh
authors: Youichi
authors: Y
authors: Kumagai
authors: Hiroyuki
authors: H
authors: Baba
authors: Keiichiro
authors: K
authors: Ishibashi
authors: Hideyuki
authors: H
authors: Ishida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Esophagogastric junction carcinoma; Siewert type II; gastric tube reconstruction