Aim: The aim of this retrospective analysis was to exclusively present the surgical results of patients with type-I–III adenocarcinomas of the esophagogastric junction thereby providing a basis for comparison with other approaches. Methods: 56 patients with Barrett’s carcinomas and 74 patients with cardial and subcardial tumors were operated on and evaluated. The surgical procedure for type-II/III carcinomas was identical: total gastrectomy, omentectomy and splenectomy with lymph node dissection after a combined left thoraco-abdominal incision. Both tumor entities were summarized into 1 group and compared with the results of surgery for Barrett’s carcinomas: subtotal esophagectomy and proximal stomach resection with lymph node dissection after right thoracotomy and an additional abdominal incision. Results: In 93% of all patients an R0 resection was possible. In patients with Barrett’s carcinomas pulmonal complications (41%) were the predominant postoperative problems. The 30-day lethality (5.3%) was higher in the group of patients with type-I carcinomas compared to those with type-II/III carcinomas (1.4%). Tumor infiltration and nodal involvement determined the prognosis after R0 resection. The presence of Barrett’s mucosa in type-I adenocarcinomas and the histological assessment according to Lauren’s classification into type-II/III carcinomas also influenced the long-term prognosis. Conclusion: After R0 resection it is not the tumor location but tumor infiltration, lymph node status and a differentiated histological assessment that determine the prognosis of patients with adenocarcinomas of the esophagogastric junction.

A special variety of pancreatic cancer is characterized by a predominant intraductal proliferation with a low-grade proliferation rate. Immunohistochemical peculiarities and the lack of lymph node metastases despite an extended tumor, distinguish it from usual ductal pancreatic carcinoma. Adenocarcinoma of the pancreas with a predominant intraductal component is proposed for its classification.

Outcomes of simultaneous resections and classical strategy for synchronous colorectal liver metastases in sweden: a nationwide study with special reference to major liver resections.

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