Risk of metastasis in adenocarcinoma of the esophagus: a multicenter retrospective study in a Japanese population
| Autor: | Masami Omae, Kenichi Goda, Masahiro Saito, Ryu Ishihara, Rie Matsuda, Akiko Takahashi, Yasuhiko Tomita, Hiroharu Yamashita, Takashi Kanesaka, Ichiro Oda, Tatsuyuki Kawano, Hiroaki Takahashi, Yosuke Tsuji, Junko Fujisaki, Soji Ozawa, Tsuneo Oyama, Mitsuru Kaise, Takashi Matsunaga, Hiroyuki Ono, Yuki Maeda, Masayoshi Yamada, Akira Matsui, Seiichiro Abe, Shuji Terai, Manabu Takeuchi, Dai Hirasawa, Shinichi Hirooka, Junichi Kodaira, Kenro Kawada, Masaki Tanaka, Tomoyuki Koike, Yasuyuki Seto |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms Adenocarcinoma Gastroenterology Metastasis 03 medical and health sciences 0302 clinical medicine Japan Risk Factors Internal medicine Submucosa medicine Humans Neoplasm Invasiveness Esophagus Aged Lymphatic Vessels Retrospective Studies Aged 80 and over business.industry Cancer Middle Aged Esophageal cancer medicine.disease Lymphovascular Tumor Burden medicine.anatomical_structure 030220 oncology & carcinogenesis Barrett's esophagus Blood Vessels Female 030211 gastroenterology & hepatology Neoplasm Grading business Follow-Up Studies |
| Zdroj: | Journal of Gastroenterology. 52:800-808 |
| ISSN: | 1435-5922 0944-1174 |
| Popis: | Little is known about the specific risks of metastasis in esophageal adenocarcinoma in relation to invasion depth or other pathologic factors.We conducted a multicenter retrospective study in 13 high-volume centers in Japan from January 2000 to October 2014 to elucidate the risk of metastasis of esophageal adenocarcinoma. A total of 458 patients (217 surgically resected and 241 endoscopically resected) with esophageal adenocarcinoma or esophagogastric adenocarcinoma involving the esophagus were included. Metastasis was considered positive if there was histologically confirmed metastasis in the surgical specimen or clinically confirmed metastasis during follow-up. Metastasis was considered negative if no metastasis was identified in resected specimens and during follow-up in patients treated surgically or no metastasis during follow-up for5 years in patients treated by endoscopic resection.Metastasis was identified in 72 patients. Multivariate analysis confirmed lymphovascular involvement [odds ratio (OR) 6.20; 95 % confidence interval (CI) 3.12-12.32; p 0.001], a poorly differentiated component (OR 3.69; 95 % CI 1.92-7.10; p 0.001), and lesion size30 mm (OR 3.12; 95 % CI 1.63-5.97; p = 0.001) as independent risk factors for metastasis. No metastasis was detected in patients with mucosal cancer without lymphovascular involvement and a poorly differentiated component (0/186 lesions) or in patients with cancer invading the submucosa (1-500 µm) without lymphovascular involvement, a poorly differentiated component, and ≤30 mm (0/32 lesions).Mucosal and submucosal cancers (1-500 µm invasion) without risk factors have a low incidence of metastasis and may thus be good candidates for endoscopic resection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink