Adenocarcinoma of the esophagogastric junction

The role of abdominal-transhiatal Resection

Fabio Carboni, Riccardo Lorusso, Roberto Santoro, Pasquale Lepiane, Pietro Mancini, Isabella Sperduti, Eugenio Santoro

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The surgical strategy for adenocarcinoma of the esophagogastric junction is still controversial. The aim of this study was to evaluate surgical results of the abdominal-transhiatal approach for 100 consecutively operated type II and III cardia adenocarcinoma, to clarify clinicopathological differences between these tumors, and to define prognostic factors. A prospectively maintained database identified 100 consecutively operated patients with Siewert type II and III cardia adenocarcinoma. Survival was analyzed by the Kaplan-Meier method. Differences between subgroups and prognostic factors were evaluated by the log rank test and Cox regression. Concerning clinicopathological characteristics, only the incidence of T1-2 stage was significantly higher in Siewert II type (P = .006). A complete (R0) resection was obtained in 74 patients (74%). Overall postoperative mortality and morbidity rates were 6% and 28%, respectively. Overall actuarial 5-year survival rate in resected patients was 27.4% (median 27 months), with 20.6% for type II and 34 for type III cancers (P = .07). Considering R0 resections, overall actuarial 5-year survival rate was 33.9% (median 33 months), with 26.7% for type II and 40.5 for type III cancer (P = .06). Pathologic T and N stage and R status were independent prognostic factors by multivariate analysis, and Siewert type showed a trend toward significance. The abdominal-transhiatal approach is a safe surgical approach, allowing complete tumor resection and adequate lymphadenectomy in these patients. True carcinoma of the cardia may be a distinct clinical entity with a more aggressive natural history than subcardial gastric carcinoma.

Original languageEnglish
Pages (from-to)304-310
Number of pages7
JournalAnnals of Surgical Oncology
Volume16
Issue number2
DOIs
Publication statusPublished - Feb 2009

Fingerprint

Esophagogastric Junction
Cardia
Adenocarcinoma
Neoplasms
Survival Rate
Carcinoma
Lymph Node Excision
Natural History
Statistical Factor Analysis
Stomach
Multivariate Analysis
Databases
Morbidity
Survival
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Carboni, F., Lorusso, R., Santoro, R., Lepiane, P., Mancini, P., Sperduti, I., & Santoro, E. (2009). Adenocarcinoma of the esophagogastric junction: The role of abdominal-transhiatal Resection. Annals of Surgical Oncology, 16(2), 304-310. https://doi.org/10.1245/s10434-008-0247-x

Adenocarcinoma of the esophagogastric junction : The role of abdominal-transhiatal Resection. / Carboni, Fabio; Lorusso, Riccardo; Santoro, Roberto; Lepiane, Pasquale; Mancini, Pietro; Sperduti, Isabella; Santoro, Eugenio.

In: Annals of Surgical Oncology, Vol. 16, No. 2, 02.2009, p. 304-310.

Research output: Contribution to journalArticle

Carboni, F, Lorusso, R, Santoro, R, Lepiane, P, Mancini, P, Sperduti, I & Santoro, E 2009, 'Adenocarcinoma of the esophagogastric junction: The role of abdominal-transhiatal Resection', Annals of Surgical Oncology, vol. 16, no. 2, pp. 304-310. https://doi.org/10.1245/s10434-008-0247-x
Carboni, Fabio ; Lorusso, Riccardo ; Santoro, Roberto ; Lepiane, Pasquale ; Mancini, Pietro ; Sperduti, Isabella ; Santoro, Eugenio. / Adenocarcinoma of the esophagogastric junction : The role of abdominal-transhiatal Resection. In: Annals of Surgical Oncology. 2009 ; Vol. 16, No. 2. pp. 304-310.
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