Skip to main content

Advertisement

SpringerLink
Log in

Comparison of the clinicopathological characteristics and the survival outcomes between the Siewert type II/III adenocarcinomas

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

The aim of the study was to analyze the clinicopathological characteristics and survival outcomes in Siewert type II and Siewert type III tumors. The clinicopathological characteristics and survival outcomes were analyzed in patients diagnosed with Siewert II/III tumors, who underwent transabdominal gastrectomy from Jan 2006 to Dec 2010. A total of 321 patients diagnosed with Siewert II/III tumors who underwent gastrectomy were enrolled in this study. Siewert III tumors are larger and have a higher proportion of Borrmann 3–4 types than Siewert II tumors (p < 0.05). For Siewert II and the Siewert III tumors, the 3-year overall survival rate was 59.1 versus 57.1 %, respectively, and the median survival time was 46.0 (31.5–60.5) months versus 46.0 (31.3–60.7) months, respectively. Positive proximal resection margin, large tumor size, Borrmann 3–4 types, poor or undifferentiated degree and advanced T stages and N stages were found to be poor prognostic risk factors for the overall survival outcomes by univariate analysis. Multivariate analysis revealed that the differentiation degree (poor and undifferentiated) and advanced T and N stages were independent prognostic factors for poor overall survival. Siewert III tumors were larger and had a lower differentiation degree than Siewert II tumors, whereas there was no difference in the survival outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.

    Article  PubMed  Google Scholar 

  2. Devesa SS, Blot WJ, Fraumeni JF. Changing patterns in the incidence of espohageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–53.

    Article  CAS  PubMed  Google Scholar 

  3. Okabayashi T, Gotoda T, Kondo H, et al. Early carcinoma of the gastric cardia in Japan: is it different from that in the West? Cancer. 2000;89(12):2555–9.

    Article  CAS  PubMed  Google Scholar 

  4. Salvon-Harman JC, Cady B, Nikulasson S, et al. Shifting proportions of gastric adenocarcinomas. Arch Surg. 1994;129(4):381–9.

    Article  CAS  PubMed  Google Scholar 

  5. Stein HJ, Feith M, Siewert JR. Cancer of the esophagogastric junction. Surg Oncol. 2000;9(1):35–41.

    Article  CAS  PubMed  Google Scholar 

  6. Siewert JR, Stein HJ. Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg. 1998;85(11):1457–9.

    Article  CAS  PubMed  Google Scholar 

  7. Rüdiger Siewert J, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg. 2000;232(3):353–61.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kodera Y, Yamamura Y, Shimizu Y, et al. Adenocarcinoma of the gastroesophageal junction in Japan: relevance of Siewert’s classification applied to 177 cases resected at a single institution. J Am Coll Surg. 1999;189(6):594–601.

    Article  CAS  PubMed  Google Scholar 

  9. von Rahden BH, Stein HJ, Siewert JR. Surgical management of esophagogastric junction tumors. World J Gastroenterol. 2006;12(41):6608–13.

    Google Scholar 

  10. Sasako M, Sano T, Yamamoto S, et al. Japan Clinical Oncology Group (JCOG9502). Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol. 2006;7(8):644–51.

    Article  PubMed  Google Scholar 

  11. Kim KT, Jeong O, Jung MR, et al. Outcomes of abdominal total gastrectomy for type II and III gastroesophageal junction tumors: single center’s experience in Korea. J Gastric Cancer. 2012;12(1):36–42.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Zhang H, Wang W, Cheng Y, et al. Adenocarcinomas of the esophagogastric junction: experiences at a single institution in China. World J Surg Oncol. 2013;11:155.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Omloo JM, Lagarde SM, Hulscher JB, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg. 2007;246(6):992–1000 discussion 1000–1001.

    Article  PubMed  Google Scholar 

  14. Hulscher JB, van Sandick JW, de Boer AG, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med. 2002;347(21):1662–9.

    Article  PubMed  Google Scholar 

  15. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.

    Article  PubMed  Google Scholar 

  16. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14(2):101–12.

    Article  Google Scholar 

  17. Blot WJ, Devesa SS, Kneller RW, et al. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991;265(10):1287–9.

    Article  CAS  PubMed  Google Scholar 

  18. Pohl H, Sirovich B, Welch HG. Esophageal adenocarcinoma incidence: are we reaching the peak? Cancer Epidemiol Biomarkers Prev. 2010;19(6):1468–70.

    Article  PubMed  Google Scholar 

  19. Fang WL, Wu CW, Chen JH, et al. Esophagogastric junction adenocarcinoma according to Siewert classification in Taiwan. Ann Surg Oncol. 2009;16(12):3237–44.

    Article  PubMed  Google Scholar 

  20. Hasegawa S, Yoshikawa T, Cho H, et al. Is adenocarcinoma of the esophagogastric junction different between Japan and western countries? The incidence and clinicopathological features at a Japanese high-volume cancer center. World J Surg. 2009;33(1):95–103.

    Article  PubMed  Google Scholar 

  21. Kodama I, Kofuji K, Yano S, et al. Lymph node metastasis and lymphadenectomy for carcinoma in the gastric cardia: clinical experience. Int Surg. 1998;83(3):205–9.

    CAS  PubMed  Google Scholar 

  22. Suttie SA, Li AG, Quinn M, et al. The impact of operative approach on outcome of surgery for gastro-oesophageal tumours. World J Surg Oncol. 2007;5:95.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Yang K, Chen HN, Chen XZ, et al. Transthoracic resection versus non-transthoracic resection for gastroesophageal junction cancer: a meta-analysis. PLoS One. 2012;7(6):e37698.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Chou SH, Chuang HY, Huang MF, et al. A prospective comparison of transthoracic and transhiatal resection for esophageal carcinoma in Asians. Hepatogastroenterology. 2009;56(91–92):707–10.

    PubMed  Google Scholar 

  25. Husemann B. Cardia carcinoma considered as a distinct clinical entity. Br J Surg. 1989;76(2):136–9.

    Article  CAS  PubMed  Google Scholar 

  26. Yonemura Y, Tsugawa K, Fonseca L, et al. Lymph node metastasis and surgical management of gastric cancer invading the esophagus. Hepatogastroenterology. 1995;42(1):37–42.

    CAS  PubMed  Google Scholar 

  27. Dresner SM, Lamb PJ, Bennett MK, et al. The pattern of metastatic lymph node dissemination from adenocarcinoma of the esophagogastric junction. Surgery. 2001;129(1):103–9.

    Article  CAS  PubMed  Google Scholar 

  28. Kawaura Y, Mori Y, Nakajima H, Iwa T. Total gastrectomy with left oblique abdominothoracic approach for gastric cancer involving the esophagus. Arch Surg. 1988;123(4):514–8.

    Article  CAS  PubMed  Google Scholar 

  29. Nakamura M, Iwahashi M, Nakamori M, et al. Lower mediastinal lymph node metastasis is an independent survival factor of Siewert type II and III adenocarcinomas in the gastroesophageal junction. Am Surg. 2012;78(5):567–73.

    PubMed  Google Scholar 

  30. Hosokawa Y, Kinoshita T, Konishi M, et al. Clinicopathological features and prognostic factors of adenocarcinoma of the esophagogastric junction according to Siewert classification: experiences at a single institution in Japan. Ann Surg Oncol. 2012;19(2):677–83.

    Article  PubMed  Google Scholar 

  31. Kawaguchi T, Komatsu S, Ichikawa D, et al. Comparison of prognostic compatibility between seventh AJCC/TNM of the esophagus and 14th JCGC staging systems in Siewert type II adenocarcinoma. Anticancer Res. 2013;33(8):3461–5.

    PubMed  Google Scholar 

  32. Suh YS, Han DS, Kong SH, et al. Should adenocarcinoma of the esophagogastric junction be classified as esophageal cancer? A comparative analysis according to the seventh AJCC TNM classification. Ann Surg. 2012;255(5):908–15.

    Article  PubMed  Google Scholar 

  33. Gertler R, Stein HJ, Loos M, et al. How to classify adenocarcinomas of the esophagogastric junction: as esophageal or gastric cancer? Am J Surg Pathol. 2011;35(10):1512–22.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to the Volunteer Team of Gastric Cancer Surgery (VOLTGA) of West China Hospital at Sichuan University in China for this substantial work. Domestic support from (1) National Natural Science Foundation of China (No. 81372344); (2) Outstanding Young Scientific Scholarship Foundation of Sichuan University, from the Fundamental Research Funds for the Central Universities of China (No. 2011SCU04B19); and (3) New Century Excellent Talents in University support program, Ministry of Education of China (2012SCU-NCET-11-0343).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, 610041, Sichuan Province, China

    Wei-Han Zhang, Xin-Zu Chen, Kai Liu, Kumar Anil, Kun Yang, Jia-Ping Chen, Zong-Guang Zhou & Jian-Kun Hu

Authors
  1. Wei-Han Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xin-Zu Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kai Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kumar Anil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kun Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jia-Ping Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zong-Guang Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jian-Kun Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jian-Kun Hu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, WH., Chen, XZ., Liu, K. et al. Comparison of the clinicopathological characteristics and the survival outcomes between the Siewert type II/III adenocarcinomas. Med Oncol 31, 116 (2014). https://doi.org/10.1007/s12032-014-0116-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0116-3

Keywords

Search

Navigation