The esophagogastric junctional adenocarcinoma an increasing disease

Pastina, Monica; Menna, Cecilia; Andreetti, Claudio; Ibrahim, Mohsen

doi:10.21037/jtd.2017.05.70

Cited by 7 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Restricting the analysis to junctional tumours had little effect on the estimates observed for the total cohort, in which high PTGS2 expression was associated with improved overall and cancer‐specific survival. It has been suggested that cancer at the gastro‐oesophageal junction is an independent disease from distal oesophageal and gastric cancer, in terms of epidemiology, risk factors, and pathophysiology . Furthermore, the approach to surgical resection is different for junctional tumours and distal adenocarcinomas, whereby cancers at the gastro‐oesophageal junction often undergo partial or total gastrectomy in addition to oesophagectomy .…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that cancer at the gastro-oesophageal junction is an independent disease from distal oesophageal and gastric cancer, in terms of epidemiology, risk factors, and pathophysiology. 30 Furthermore, the approach to surgical resection is different for junctional tumours and distal adenocarcinomas, whereby cancers at the gastro-oesophageal junction often undergo partial or total gastrectomy in *0 = no staining; 1 = weak intensity; 2 = moderate-strong intensity in 10-90% of cells; 3 = strong intensity in >90% of cells. †0 = no staining; 1 = weak intensity; 2 = medium intensity; 3 = strong intensity; multiplied by score for percentage of cells stained (0 = 0-4%; 1 = 5-29%; 2 = 30-59%; 3 = 60-100%).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High PTGS2 expression in post‐neoadjuvant chemotherapy‐treated oesophageal adenocarcinoma is associated with improved survival: a population‐based cohort study

et al. 2019

View full text Add to dashboard Cite

Aims High prostaglandin endoperoxide synthase‐2 (PTGS2) enzyme expression in oesophageal adenocarcinoma has been shown to independently predict poor prognosis; however, the evidence is inconsistent. The aim of this study was to investigated the association between PTGS2 expression and prognosis in patients with oesophageal adenocarcinoma. Methods and results A cohort of 135 patients with oesophageal adenocarcinoma who received neoadjuvant chemotherapy and surgery from 2004 to 2012 was identified in the Northern Ireland Cancer Centre. Tissue microarrays were created in the Northern Ireland Biobank, with triplicate cores being sampled from each tumour. Immunohistochemical PTGS2 expression was scored by two independent assessors, with intensity and proportion of tumour staining being used to calculate H‐scores for each patient. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for overall and cancer‐specific survival, and recurrence‐free survival by PTGS2 expression, with adjustment for potential confounders. Patients were followed up for a mean of 3.0 years (standard deviation 1.8 years). The PTGS2 expression cut‐off value was determined from the median H‐score of the cohort (270/300). High (n = 79), as compared with low (n = 56), PTGS2 expression was associated with improved cancer‐specific survival (adjusted HR 0.56, 95% CI 0.33–0.94; P = 0.03). PTGS2 expression was not significantly associated with recurrence‐free survival (adjusted HR 0.85, 95% CI 0.52–1.38; P = 0.51). Conclusions High PTGS2 expression in oesophageal adenocarcinoma tissue was associated with improved overall and cancer‐specific survival, in contrast to previous evidence. As this is the first study of its kind to include patients who had undergone neoadjuvant chemotherapy, further studies are needed to clarify these associations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High PTGS2 expression in post‐neoadjuvant chemotherapy‐treated oesophageal adenocarcinoma is associated with improved survival: a population‐based cohort study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The incidence of proximal gastric cancer (GC) has been gradually increasing globally [1][2][3]. Although radical total gastrectomy (TG) is still the preferred treatment modality for locally advanced proximal gastric cancer (LAPGC), whether it is essential to dissect the splenic hilar (No.…”

Section: Introductionmentioning

confidence: 99%

Reappraise role of No. 10 lymphadenectomy for proximal gastric cancer in the era of minimal invasive surgery during total gastrectomy: a pooled analysis of 4 prospective trial

Zhong

Chen

et al. 2020

Gastric Cancer

View full text Add to dashboard Cite

Background For patients with locally advanced proximal gastric cancer (LAPGC), the individualized selection of patients with highly suspected splenic hilar (No. 10) lymph node (LN) metastasis to undergo splenic hilar lymphadenectomy, is a clinical dilemma. This study aimed to re-evaluate the feasibility and safety of laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPSHL) and to identify the population who would benefit from it. Methods A total of 1068 patients (D2 group = 409; D2 + No. 10 group = 659) who underwent laparoscopic total gastrectomy from four prospective trials between January 2015 and July 2019 were analyzed. Results No significant difference in the incidence (16.9% vs. 16.4%; P = 0.837) of postoperative complications were found between the two groups. The metastasis rate of No. 10 LN among patients in the D2 + No. 10 group was 10.3% (68/659). Based on the decision tree, patients with LAPGC with tumor invading the greater curvature (Gre), patients with non-Greinvading LAPGC with a tumor size > 5 cm and clinical positive locoregional LNs were defined as the high-priority No. 10 dissection group. The metastasis rate of No. 10 LNs in the high-priority group was 19.4% (41/211). In high-priority group, the 3-year overall survival of the D2 + No. 10 group was better than that of the D2 group (74.4% vs. 42.1%; P = 0.005), and the therapeutic index of No. 10 was higher than the indices of most suprapancreatic stations. Conclusions LSPSHL for LAPGC is safe and feasible when performed by experienced surgeons. LSPSHL could be recommended for the high-priority group patients even without invasion of the Gre.

show abstract

“…In recent years, gastric cancer has tended to migrate proximally (3), and the incidence of proximal gastric cancer has increased (4). The metastatic rate of the splenic hilar LNs for gastric cancers in the middle-upper or one-third was about 8.8% to 20.9% according to the reported data (5,6).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic splenic hilar lymph node dissection for advanced gastric cancer: to be or not to be

Ma¹,

Shi²,

Chen³

et al. 2019

Ann. Transl. Med.

View full text Add to dashboard Cite

The incidence of proximal gastric cancer has increased in both the East and the West. Although some novel reconstructions like double-tract or double-flap anti-reflux procedure related to proximal gastrectomy are promising, total radical gastrectomy still accounts for a significant portion of these procedures. D2 radical gastrectomy is the globally accepted standard surgical procedure for advanced gastric cancer, and lymph node (LN) dissection is considered as the critical point of radical surgery and closely related to the prognosis. The splenic hilar LNs (No. 10) are LNs that need to be removed during standard D2 surgery for proximal and total gastrectomy. Lymphadenectomy does not only provide valuable information on the prognosis of gastric cancer, but the thoroughness of the sweep itself is directly related to postoperative survival. The incidence of splenic hilar LN (No. 10) metastasis rate is not high. Although the LN metastasis pathway around the spleen is complicated, the feasibility of laparoscopic splenic hilar LN dissection in locally advanced gastric cancer has been verified. However, these results are mostly from small volume clinical studies, and the fact is that the dissection of the splenic hilar is technique-demanding even for open surgery. The rational strategy for LN dissection for surgeons is still controversial. For splenic LN dissection in radical gastric cancer surgery, whether to select individualized splenic LN dissection for those patients highly suspected of clinical metastasis or to advocate the evidence-based strategy and neglect dissection in lower risk patients to avoid over-removing of LNs, is a vital question that needs to be clarified.

show abstract

The esophagogastric junctional adenocarcinoma an increasing disease

Cited by 7 publications

References 22 publications

High PTGS2 expression in post‐neoadjuvant chemotherapy‐treated oesophageal adenocarcinoma is associated with improved survival: a population‐based cohort study

High PTGS2 expression in post‐neoadjuvant chemotherapy‐treated oesophageal adenocarcinoma is associated with improved survival: a population‐based cohort study

Reappraise role of No. 10 lymphadenectomy for proximal gastric cancer in the era of minimal invasive surgery during total gastrectomy: a pooled analysis of 4 prospective trial

Laparoscopic splenic hilar lymph node dissection for advanced gastric cancer: to be or not to be

Contact Info

Product

Resources

About