Impact of number and site of lymph node invasion on survival of adenocarcinoma of esophagogastric junction☆

Abstract

Lymph node involvement in adenocarcinoma of the esophagogastric junction (EGJ) is similar to that of gastric cancer. The impact on survival of the number and site of lymph nodes involved in a subgroup of patients undergone surgery for adenocarcinoma of EGJ is reported. Sixty-four patients undergone transthoracic esophagectomy with two-field lymphadenectomy for adenocarcinoma of the EGJ were retrospectively assessed. Five-year survival according to AJCC gastric cancer nodal classification and central node invasion was evaluated. In N0 patients survival was assessed in relation to the number of lymph nodes removed. Five-year survival was 72% in N0, 46% in N1 and 0% in N2 and N3 group. Intergroup differences were statistically significant (P<0.05) except between N2 and N3 groups. Overall survival was different depending on the infiltration of distal or proximal site nodes, 23% vs. 58% (P<0.05); in N0 patients it was related to the number of lymph nodes removed (83% >15 vs. 57% <15, P<0.05). Classification of lymph node involvement in adenocarcinoma of the EGJ by gastric cancer criteria is adequate for prognostic purposes. The involvement of distal nodes in all cases and the removal of <15 nodes in N0 group resulted as independent negative predictive factors.

Lymphatic vessel invasion detected by the endothelial lymphatic marker D2-40 (podoplanin) is predictive of regional lymph node status and an independent prognostic factor in patients with resected esophageal cancer

“…90-97) Key words: esophageal cancer, lymphatic vessel invasion, podoplanin, D2-40, lymph node metastasis, prognosis ageal cancer. More than 65% of patients with localized esophageal cancers and negative resection margin have a positive lymph node at the time of surgery [1]. However, despite complete tumor resection and extensive lymphadenectomy, systemic and local recurrence is common [2] and the five-year survival rate is 15-39% [3].…”

Short‐term postoperative complications and prognostic factors in patients with adenocarcinoma of the esophagogastric junction

“…Fiveyear survival rates of T1 and T2 esophageal cancer patients are reported at 82% and 72%, respectively. 20 However, the five-year survival rate is 0 for patients with T3 or T4 disease. 20 Koufuji et al reported five-year survival rates of stage I, II, III, and IV of 86%, 40%, 21%, and 0, respectively.…”

Tumor Volume of Resectable Adenocarcinoma of the Esophagogastric Junction at Multidetector CT: Association with Regional Lymph Node Metastasis and N Stage

“…Subsequently, the circumference of the AEG was manually drawn nodes. In the upper abdomen, nodes located along the cardia, lesser and large curvature, left gastric artery, celiac axis, common hepatic artery, and splenic artery were removed (16,17).…”