Esophagogastric Metaplasia Relates to Nodal Metastases in Adenocarcinoma of Esophagus and Cardia

Ruffato, Alberto; Mattioli, Sandro; Perrone, Ottorino; Lugaresi, Marialuisa; Simone, Massimo Pierluigi Di; D’Errico, Antonietta; Malvi, Deborah; Aprile, M; Raulli, Gian Domenico; Frassineti, Giovanni Luca

doi:10.1016/j.athoracsur.2012.12.040

Cited by 11 publications

(23 citation statements)

References 22 publications

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“…Therefore, in terms of metastatic pattern, type II AEGs with an “atrophic” background are more similar to type III than to type II AEG with a “non‐atrophic” background. In addition, a previous study analyzing a series of adenocarcinomas of the esophagus and cardia demonstrated that tumors without IM in the stomach more frequently involved pancreatic nodes and celiac trunk nodes than tumors with IM (24/43 vs 7/61, P < 0.001; 18/139 vs 3/84, P = 0.02, respectively) . These observations may reflect different biologic behaviors and possibly different carcinogenic pathways within type II AEGs, which could potentially be distinguished by background mucosal condition.…”

Section: Discussionmentioning

confidence: 88%

“…In addition, a previous study analyzing a series of adenocarcinomas of the esophagus and cardia demonstrated that tumors without IM in the stomach more frequently involved pancreatic nodes and celiac trunk nodes than tumors with IM (24/43 vs 7/61, P < 0.001; 18/139 vs 3/84, P = 0.02, respectively). 33 These observations may reflect different biologic behaviors and possibly different carcinogenic pathways within type II AEGs, which could potentially be distinguished by background mucosal condition. Although we must be cautious when interpreting these findings because of the small number of cases analyzed and the absence of multivariate estimation, background mucosal condition may serve as a predictor of the pattern of nodal metastasis in patients with type II AEG.…”

Section: Discussionmentioning

confidence: 99%

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Adenocarcinoma of the esophagogastric junction and its background mucosal pathology: A comparative analysis according to Siewert classification in a Japanese cohort

et al. 2018

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Adenocarcinoma of the esophagogastric junction (AEG) has heterogeneous carcinogenic process due to its location straddling the esophagogastric junction. We assessed background mucosal pathology and its correlation with clinicopathological features of each Siewert type of AEG. Clinicopathological and immunohistochemical analyses of 103 AEGs and 58 gastric cancers (GCs) were conducted. Background mucosal features were evaluated according to the updated Sydney System. Siewert classification divided 103 AEGs into three type I, 75 type II, and 25 type III tumors, respectively. Two type I, 9 type II AEGs, and none of type III AEGs were Barrett‐related and were excluded from further analysis. Background mucosa of type III AEGs more frequently showed moderate to marked degree of atrophy and intestinal metaplasia than those of type II AEGs and was very similar to those of GCs. Among type II AEGs, tumors with atrophic background were significantly associated with higher patient age and intestinal‐type histology. Type II AEGs with nonatrophic background, but not those with atrophic background, showed more frequent mismatch repair deficiency, TP53 overexpression, and less frequent intestinal phenotypic markers expression than type III AEG or GC. Type II AEGs with atrophic background involved suprapancreatic nodes more frequently than those without. We demonstrated that chronic atrophic gastritis was a major precancerous condition of AEG in the Japanese population, especially Siewert type III which had background mucosal pathology similar to that of GC. Type II AEGs with and without atrophic background showed some clinicopathological differences, and these observations might represent heterogeneous carcinogenic process within type II AEGs.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma of the esophagogastric junction and its background mucosal pathology: A comparative analysis according to Siewert classification in a Japanese cohort

et al. 2018

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“…We considered patients with adenocarcinoma of the esophagus who were operated on between 2001 and 2013. The majority of the considered cases had been included in a previous study in which diagnosis, surgical procedure, pathologic workup, and follow-up were extensively described [11].…”

Section: Methodsmentioning

confidence: 99%

“…The preoperative workup included medical history and symptoms, upper gastrointestinal tract endoscopy with multiple biopsies of the tumor and surrounding mucosa and fundic and antral mucosa, and thoracoabdominal computed tomography (CT), positron emission tomography (PET), or CT-PET. Patients clinically defined as stage T1-3N0-1 were not given neoadjuvant therapy [11]. Cases were staged pathologically according to the sixth edition of the American Joint Committee on Cancer/Union for International Cancer Control TNM classification system [12] and restaged according to the seventh edition [13] for the present study.…”

Section: Methodsmentioning

confidence: 99%

“…It is unclear if the survival improvement statistically linked with the extent of a lymphadenectomy results from stage migration phenomena or therapeutic effects [1,3,8]. Using a prospective protocol established in the 1990s, our tertiary center operated on a series of patients with adenocarcinomas of the esophagus and cardia who were not given neoadjuvant therapy [10,11]. The protocol defined the resection area, the resection of all visible lymph nodes with the surrounding cellular tissue of defined lymph node thoracic and abdominal stations, a research-dedicated pathologic study of the specimen, and the follow-up.…”

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confidence: 99%

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