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International Session (Symposium)3 (JSGS・JSGE・JGES)
Fri. October 13th   14:00 - 17:00   Room 1: Fukuoka Kokusai Center Arena
Surgical and therapeutic strategy for carcinoma in the esophagogastric junction
M. Nakamori1, M. Nakamura1, H. Yamaue1
1Second Department of Surgery, Wakayama Medical University, School of Medicine
Background and Methods: The appropriate surgical procedure and extent of lymph node dissection for carcinoma in the esophagogastric junction (EGJ). The aim of this study is to evaluate surgical procedure according to the clinicopathological features. Between 1991 and 2016, 75 patients with carcinoma in the GEJ (Siewert type II and III) underwent primary surgical resection. Results: The overall 5-year survival rates in patients with type II tumors and type III tumors were 44.2 per cent and 41.4 per cent, respectively, with no significant differences. The independent survival factors were lower mediastinal lymph node metastasis and a noncurative resection. The independent survival factors for patients who underwent curative resections were the tumor size, M category, and lower mediastinal lymph node metastasis. In addition, the distance from the EGJ to the proximal edge of primary tumor may be an indicator of metastases in the mediastinal lymph nodes. Conclusions: In patients with adenocarcinoma in the EGL (Siewert type II and III), lower mediastinal lymph node metastasis may be an independent survival factor, and also lower mediastinal lymph node metastasis was associated with distant metastasis. Therefore, we need to modify the surgical approach such as in the prone position.
Index Term 1: esophagogastric junction
Index Term 2: surgery
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