Adenocarcinoma of the gastroesophageal junction in Japan: relevance of Siewert’s classification applied to 177 cases resected at a single institution
Autor: | Kenzo Yasui, Yasuhiro Shimizu, Tomoyuki Kato, Takeshi Morimoto, Yasuhiro Kodera, Takashi Hirai, Akihito Torii, Yoshitaka Yamamura |
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Rok vydání: | 1999 |
Předmět: |
Male
medicine.medical_specialty Databases Factual medicine.medical_treatment Adenocarcinoma Gastroenterology Metastasis Japan Gastrectomy Stomach Neoplasms Internal medicine Epidemiology medicine Carcinoma Humans business.industry Esophageal disease Cancer Middle Aged Prognosis medicine.disease Survival Analysis Lymph Node Excision Female Surgery Lymphadenectomy Esophagogastric Junction business |
Zdroj: | Journal of the American College of Surgeons. 189:594-601 |
ISSN: | 1072-7515 |
Popis: | Background: There had been a lack of international consensus about the definition of cancer of the gastric cardia until Siewert's classification was approved at a consensus conference during the second International Gastric Cancer Congress held in 1997. Study Design: A review of the prospective gastric cancer database at Aichi Cancer Center from 1983 to 1992 identified 1,913 gastric carcinoma patients who underwent gastrectomy. These patients were classified retrospectively according to the Siewert classification, and 177 patients who fell into one of the three types form the basis of this study. Survival analyses were performed after stratifying patients by clinicopathologic variables. Results: There were 33 patients with type II and 144 with type III, although none had type I, a type frequently observed in the west. No evidence of a change in the frequency of types II or III cancers (approximately 9.3% overall) among gastric carcinoma patients was observed over the 10-year period. Clinical staging of gastric carcinoma by the TNM classification was found to reflect accurately the prognosis of these patients. There were no longterm survivors among the few patients with metastasis to the perigastric nodes of the distal stomach. Conclusions: A striking difference in the distribution of types of adenocarcinoma of the gastroesophageal junction was observed in Japan compared with previously reported western data. A subgroup of carcinoma of the proximal stomach identified as types II and III may not require proximal gastrectomy from the viewpoint of sufficient lymphadenectomy. |
Databáze: | OpenAIRE |
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