Comparison of advanced adenocarcinomas of esophagogastric junction and distal stomach in Japanese patients

Abstract

Background There have been no reports on the incidence, characteristics, treatment outcomes, and prognosis of inoperably advanced or recurrent adenocarcinoma of the esophagogastric junction (AEGJ) in Japan. Methods We investigated the clinicopathological characteristics, treatment outcomes, and prognosis for 816 patients with esophagogastric junctional and gastric adenocarcinoma who received first-line chemotherapy between 2004 and 2009. Results Of 816 patients, 82 (10 %) had AEGJ. The patients with AEGJ had significantly more lung and lymph node metastasis, but less peritoneal metastasis, than those with gastric adenocarcinoma (GAC). The objective response rate to first-line chemotherapy was 23.3 % for patients with AEGJ and 22.6 % in patients with GAC (p = 0.90). The median survival was 13.0 months in AEGJ and 11.8 months in GAC (p = 0.445). In no patient was tumor site a significant prognostic factor (p = 0.472). In patients with AEGJ, ECOG PS C 2, presence of liver metastasis, and absence of lung metastasis were significantly associated with poor prognosis. Conclusions No significant differences were observed in treatment outcomes between advanced AEGJ and GAC. Therefore, the same chemotherapy regimen can be given as a treatment arm in future Japanese clinical trials to both patients with inoperably advanced or recurrent AEGJ and those with GAC.

Survival predictors associated with signet ring cell carcinoma of the esophagus (SRCCE): A population-based retrospective cohort study

“…Furthermore, comprehensive managements for the treatment of peritoneal carcinomatosis, including Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy, have already been suggested and showed encouraging results [37, 38]. However, in a retrospective study of 816 cases, Akiko et al [39] found that adenocarcinoma of the esophagogastric junction had more regional lymph node and lung metastasis but less peritoneal metastasis compared with gastric adenocarcinoma.…”

Clinical practice guidelines for esophagogastric junction cancer: Upper GI Oncology Summit 2023

“…The retrospective studies examined the treatment outcomes of first-line therapies in patients with gastric adenocarcinoma and esophagogastric junction adenocarcinoma. The results showed no significant differences in the overall survival between the two groups [ 126 , 128 ].…”