Can proximal Gastrectomy Be Justified for Advanced Adenocarcinoma of the Esophagogastric Junction?

Yuya Sato; Hitoshi Katai; Maiko Ito; Masahiro Yura; Sho Otsuki; Yukinori Yamagata; Shinji Morita

doi:10.5230/jgc.2018.18.e33

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자료유형: 학술저널

저자정보: Yuya Sato (National Cancer Center Hospital) Hitoshi Katai (National Cancer Center Hospital) Maiko Ito (National Cancer Center Hospital) Masahiro Yura (National Cancer Center Hospital) Sho Otsuki (National Cancer Center Hospital) Yukinori Yamagata (National Cancer Center Hospital) Shinji Morita (National Cancer Center Hospital)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제18권 제4호

발행연도: 2018.12

수록면: 339 - 347 (9page)

DOI: 10.5230/jgc.2018.18.e33

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Purpose: To evaluate the status of number 3b lymph node (LN) station in patients with adenocarcinoma of the esophagogastric junction (AEG) and to investigate the optimal indications for radical proximal gastrectomy (PG) for AEG. Materials and Methods: Data of 51 patients with clinically advanced Siewert types II and III AEG who underwent total gastrectomy (TG) between April 2010 and July 2017 were reviewed. The proportion of metastatic LNs at each LN station was examined. Number 3 LN station was separately classified into number 3a and number 3b. The risk factors for number 3b LN metastasis and the clinicopathological features of number 3b-positive AEG patients were investigated. Results: The incidences of LN metastasis were the highest in number 1 (47.1%), followed by number 2 (23.5%), number 3a (39.2%), and number 7 (23.5%) LN stations. LN metastasis in number 3b LN station was detected in 4 patients (7.8%). A gastric invasion length of more than 40 mm was a significant risk factor for number 3b LN metastasis. All 4 patients with number 3b-positive AEG had advanced cancer with a gastric invasion length of more than 40 mm. The 5-year survival rate of patients with a gastric invasion length of more than 40 mm was 50.0%. Conclusions: Radical PG may be indicated for patients with AEG with gastric invasion length of less than 40 mm.

#Adenocarcinoma of the esophagogastric junction #Proximal gastrectomy #Lesser curvature lymph nodes #Esophagogastric junction

참고문헌 (20)

참고문헌 신청

Yamashita K / 2011 / Trend in gastric cancer: 35 years of surgical experience in Japan / World J Gastroenterol 17:3390~3397

Kusano C / 2008 / Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan / J Gastroenterol Hepatol 23:1662~1665

Pohl H / 2005 / The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence / J Natl Cancer Inst 97:142~146

Japanese Gastric Cancer Association / 2017 / Japanese gastric cancer treatment guidelines 2014 (ver. 4) / Gastric Cancer 20:1~19

Yoshikawa T / 2016 / Theoretical therapeutic impact of lymph node dissection on adenocarcinoma and squamous cell carcinoma of the esophagogastric junction / Gastric Cancer 19:143~149

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