Prognostic and Clinicopathological Significance of Lymph Node Metastasis in the Esophagogastric Junction Adenocarcinoma

Abstract

Background: This study aimed to identify prognostic factors for adenocarcinoma of the esophagogastric junction (AEG) in Siewert type II and characterize the population whose prognosis is expected to improve. Patients and Methods: We retrospectively reviewed a database of 68 AEG type II patients who had undergone surgical curative resection without preoperative treatment. Results: Although patients with pathological N0 (pN0) showed favorable 3-year disease-free survival (91%), patients with pN1-3 had poor outcomes (42%, 23%, and 10%). Multivariate analyses showed that the only independent prognostic factor was lymph node metastasis, and that tumor depth (cT3-4) and tumor size (≥4 cm) were correlated closely with lymph node metastasis. Conclusion: Surgical curative resection without preoperative treatment is insufficient to treat AEG type II with lymph node metastasis. Among AEG patients, those with the high-risk factors of preoperative tumor depth (T3-4) or/and size (≥4 cm) might need intensive multimodal treatment, including perioperative adjuvant chemotherapy.