| International Session (Symposium) 3 (1) (JSGS・JSGE・JSH) |
| Fri. November 2nd 9:00 - 10:30 Room 9: Portopia Hotel Main Building Kairaku 3 |
| Is it necessary to dissect upper mediastinum for patients with adenocarcinoma of the esophagogastiric junction? | |||
| Shinji Mine1, Masayuki Watanabe1, Yu Imamura1 | |||
| 1Department of Esophageal surgery, Cancer Institute Hospital Ariake | |||
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| Background: Although surgical resection is the mainstay of curative treatment for adenocarcinoma of the esophagogastric junction (AEG), the proper extent of lymphadenectomy for AEG has not yet been decided. We have applied esophagectomy including upper mediastinal (UM) lymphadenectomy for patients with AEG of Siewert type I tumors or type II with esophageal invasion > 3 cm. In this study, we retrospectively reviewed the outcomes of this intervention. Methods: From 2009 to 2017, 86 patients with AEG underwent esophagectomy via a right thoracotomy or minimally invasive esophagectomy (MIE) in our department. Clinical and pathological findings were investigated. Results: 34 patients underwent open thoracotomy and other 52 received MIE. In 30 patients, UM lymphadenectomy was omitted due to co-morbidity or early disease. 30 patients had cStage I, and other 51 patients had cStage II~IV. Of 86 patients, 31 (36%) had mediastinal nodal involvements and 50 (58%) had abdominal nodal involvements. Of all 86 patients, 15 (17%) had UM involvements. Of 12 patients who had UM involvements and could be followed at least 1 year, only 2 patients had no relapse of disease. In addition, of 5 patients diagnosed as having UM involvements preoperatively, only 1 patient had no relapse of disease. Conclusions: Although the incidence of nodal involvements in UM area of AEG patients was relatively high, the prognosis of patients with UM involvements was poor. The necessity for UM lymphadenectomy for AEG patients will be decided by the results of ongoing prospective study of the Japanese Gastric Cancer Association and the Japanese Esophageal Society. |
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Index Term 1: adenocarcinoma of the esophagogastric junction Index Term 2: lymphadenectomy |
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