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Langenbeck's Archives of Surgery

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08.06.2020 | Original Article

Distribution of lymph node metastases in locally advanced adenocarcinomas of the esophagogastric junction (cT2-4): comparison between Siewert type I and selected Siewert type II tumors

verfasst von: Akio Sakaki, Jun Kanamori, Koshiro Ishiyama, Daisuke Kurita, Junya Oguma, Hiroyuki Daiko

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 4/2020

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Abstract

Introduction

The distribution of lymph node metastases in locally advanced Siewert type I and type II AEG (adenocarcinoma of the esophagogastric junction) remains unclear. The diversity of data in the literature reflects the non-uniformity of tumor stages and surgical procedures in previous studies.

Materials and methods

Based on a retrospective analysis from our single-center database, we examined distributions of lymph node metastases in types I and II cT2-4 AEG. The dataset comprised 44 patients; 19 and 25 patients had type I and type II, respectively. All patients underwent subtotal esophagectomy and total mediastinal lymphadenectomy, which included dissection of the upper mediastinal lymph nodes. The histological data of the surgical specimens were analyzed to evaluate metastasis rates in each lymph node station according to the Japanese Esophageal Society (JES) and American Joint Committee on Cancer (AJCC) guidelines.

Results

Lymph node metastases were observed in 75.0% cases (n = 33/44). There was no significant difference in the total lymph node metastasis rate between the two groups (type I 73.7% versus type II 76.0%). On comparing each lymph node region separately, no statistically significant differences were noted between the groups: upper mediastinal (type I 31.6% versus type II 24.0%), middle and lower mediastinal (type I 31.6% versus type II 44.0%), paragastric (type I 61.1% versus type II 76.0%), and celiac lymph nodes (type I 16.7% versus type II 25.0%).

Conclusion

In advanced clinical stages, the metastasis rate is high at all mediastinal lymph node regions in both type I and type II AEGs.

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Titel: Distribution of lymph node metastases in locally advanced adenocarcinomas of the esophagogastric junction (cT2-4): comparison between Siewert type I and selected Siewert type II tumors
verfasst von: Akio Sakaki
Jun Kanamori
Koshiro Ishiyama
Daisuke Kurita
Junya Oguma
Hiroyuki Daiko
Publikationsdatum: 08.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Langenbeck's Archives of Surgery / Ausgabe 4/2020
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01894-z

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Abstract

Introduction

Materials and methods

Results

Conclusion

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