The optimal extent of lymph node dissection in gastroesophageal junctional cancer: retrospective case control study.
Abdomen
Adenocarcinoma
/ mortality
Aged
Case-Control Studies
Chemotherapy, Adjuvant
/ adverse effects
Disease-Free Survival
Esophageal Neoplasms
/ mortality
Esophagectomy
Esophagogastric Junction
/ pathology
Female
Follow-Up Studies
Gastrectomy
Humans
Lymph Node Excision
/ adverse effects
Lymph Nodes
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Neoplasm Staging
Postoperative Complications
Prognosis
Republic of Korea
Retrospective Studies
Survival Rate
Gastric cancer
Gastroesophageal junction cancer
Lymphadenectomy
Mediastinal lymph node dissection
Siewert type
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
22 Jul 2019
22 Jul 2019
Historique:
received:
22
08
2018
accepted:
11
07
2019
entrez:
24
7
2019
pubmed:
25
7
2019
medline:
1
1
2020
Statut:
epublish
Résumé
Recently, the incidence of gastroesophageal junction (GEJ) cancer has been increasing in Eastern countries. Mediastinal lymph node (MLN) metastasis rates among patients with GEJ cancer are reported to be 5-25%. However, survival benefits associated with MLN dissection in GEJ cancer has been a controversial issue, especially in Eastern countries, due to its rarity and potential morbidity. We retrospectively reviewed 290 patients who underwent surgery for GEJ cancer at the National Cancer Center in Korea from June 2001 to December 2015. Clinicopathologic characteristics and surgical outcomes were compared between patients without MLN dissection (Group A) and patients with MLN dissection (Group B). Prognostic factors associated with the survival rate were identified in a multivariate analysis. Twenty-nine (10%) patients underwent MLN dissection (Group B). Three of 29 patients (10.3%) showed a metastatic MLN in Group B. For abdominal LNs, the 5-year disease-free survival rate was 79.5% in Group A and 33.9% in Group B (P < 0.001). The multivariate analysis revealed that abdominal LN dissection, pT category, and pN category were statistically significant prognostic factors. LNs were the most common site for recurrence in both groups. Abdominal LN dissection and pathologic stage are the important prognostic factors for type II and III GEJ cancer rather than mediastinal lymph node dissection.
Sections du résumé
BACKGROUND
BACKGROUND
Recently, the incidence of gastroesophageal junction (GEJ) cancer has been increasing in Eastern countries. Mediastinal lymph node (MLN) metastasis rates among patients with GEJ cancer are reported to be 5-25%. However, survival benefits associated with MLN dissection in GEJ cancer has been a controversial issue, especially in Eastern countries, due to its rarity and potential morbidity.
METHODS
METHODS
We retrospectively reviewed 290 patients who underwent surgery for GEJ cancer at the National Cancer Center in Korea from June 2001 to December 2015. Clinicopathologic characteristics and surgical outcomes were compared between patients without MLN dissection (Group A) and patients with MLN dissection (Group B). Prognostic factors associated with the survival rate were identified in a multivariate analysis.
RESULTS
RESULTS
Twenty-nine (10%) patients underwent MLN dissection (Group B). Three of 29 patients (10.3%) showed a metastatic MLN in Group B. For abdominal LNs, the 5-year disease-free survival rate was 79.5% in Group A and 33.9% in Group B (P < 0.001). The multivariate analysis revealed that abdominal LN dissection, pT category, and pN category were statistically significant prognostic factors. LNs were the most common site for recurrence in both groups.
CONCLUSION
CONCLUSIONS
Abdominal LN dissection and pathologic stage are the important prognostic factors for type II and III GEJ cancer rather than mediastinal lymph node dissection.
Identifiants
pubmed: 31331305
doi: 10.1186/s12885-019-5922-8
pii: 10.1186/s12885-019-5922-8
pmc: PMC6647315
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
719Subventions
Organisme : National Cancer Center, Korea
ID : NCC 1710160-1
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