Lower Mediastinal Lymph Node Metastasis is an Independent Survival Factor of Siewert Type II and III Adenocarcinomas in the Gastroesophageal Junction
Autor: | Makoto Iwahashi, Toshiaki Tsuji, Keiji Hayata, Hiroki Yamaue, Masahiro Katsuda, Takeshi Iida, Mikihito Nakamori, Masaki Nakamura, Shuuichi Mastumura, Teiji Naka, Toshiyasu Ojima |
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Rok vydání: | 2012 |
Předmět: |
Male
Oncology medicine.medical_specialty medicine.medical_treatment Adenocarcinoma Gastroesophageal Junction Gastroenterology Endoscopy Gastrointestinal Endosonography Metastasis Japan Gastrectomy Risk Factors Stomach Neoplasms Internal medicine medicine Humans Aged Neoplasm Staging Retrospective Studies medicine.diagnostic_test business.industry Mediastinum Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Endoscopy Survival Rate medicine.anatomical_structure Lymphatic Metastasis Mediastinal lymph node Lymph Node Excision Female Esophagogastric Junction Tomography X-Ray Computed business Follow-Up Studies |
Zdroj: | The American Surgeon. 78:567-573 |
ISSN: | 1555-9823 0003-1348 |
Popis: | We examined clinicopathological features and surgical outcomes in patients with adenocarcinoma in the gastroesophageal junction (GEJ), while also analyzing the survival factors that have a prognostic impact. Between 1991 and 2009, 61 patients with tumors in the GEJ (Siewert type II and III) underwent primary surgical resection. Thirty of 61 patients had type II tumors (49.2%) and 31 had type III tumors (50.8%). The tumor size was larger in type III tumors than type II tumors ( P = 0.0026). The overall 5-year survival rates in patients with type II tumors and type III tumors were 44.2 per cent and 41.4 per cent, respectively, with no significant differences ( P = 0.1888). The independent survival factors were lower mediastinal lymph node metastasis ( P = 0.0323) and a noncurative resection ( P = 0.0442). The independent survival factors for patients who underwent curative resections were the tumor size ( P = 0.0422), M category ( P = 0.0489), and lower mediastinal lymph node metastasis ( P = 0.0482). This study showed lower mediastinal lymph node metastasis to be an independent survival factor, and also suggested that lower mediastinal lymph node metastasis was associated with distant metastasis in patients with adenocarcinoma in the GEJ (Siewert type II and III). Therefore, the preoperative early detection of such metastasis is important to improve patient survival. |
Databáze: | OpenAIRE |
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