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International Session (Symposium)3 (JSGS・JSGE・JGES)
Fri. October 13th   14:00 - 17:00   Room 1: Fukuoka Kokusai Center Arena
The treatment strategy of the advanced esophago-junctional adenocarcinoma (Siewert typeII)
K. Narumiya1, H. Osugi1, M. Yamamoto1
1Tokyo Women's Medical University
(Introduction) Incidence of adenocarcinoma of the esophagogastric junction is increasing in Japan. However, there is poor prognosis and no consensus on treatment strategy.(Purpose) We study the treatment strategy of the advanced esophago-junctional adenocarcinoma according to the lymph node metastasis (Methods) We retrospectively examined data from a total of 50 patients of advanced esophago-junctional adenocarcinoma (Siewert typeII) (1) Back ground (2) Index (metastatic rate x 3-year OS/100) (Results) (1) Depth of tumor invasion (T2:T3:T4=6:41:3) (2) Approach (thoracotomy: transheatal) 37:13 (3) Recurrence (Lymph:liver:lung:dissemination) =16:5:1:6 (4) Range of the lymph node metastasis (Cervical:upper mediastinum:middle mediastinum:lower mediastinum:abdominal) =1:1:3:10:31 (5) Index No1:No2:No3:No.7:No11:No20:No110:No112=12.1:10.6:12.9:13.5:18.1:50:12.9:9.09(Conclusion) According to the Index,the range ofdissection of lymph node were lower mediastinum and abdominal lymph node.Surgical treatment with appropriate lymph node dissection was short of power for advanced esophago-junctional adenocarcinoma.I t is necessary to develop new adjuvant therapy.(Discussion) We began to perform Phase I trial of Nabpaclitaxel combinated radiotherapy for advanced adenocarcinoma of the esophago-gastric junction before operation thorough suitably constituted Ethics Committee of our institute.We will show the result.
Index Term 1: Siewert type II
Index Term 2: lymph node dissection
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