Is gastric tube reconstruction the optimal surgical procedure for Siewert type II esophagogastric junction carcinoma?

Anticancer Res. 2014 Feb;34(2):915-9.

Abstract

Background/aim: To evaluate the potential risk of gastric tube reconstruction for Siewert type II esophagogastric junction carcinoma.

Patients and methods: We retrospectively analyzed clinicopathological and survival data of 41 patients who had undergone total gastrectomy for Siewert type II carcinoma, focusing on lymph node metastasis around the middle to lower greater curvature or parapyloric area.

Results: Histological examination showed involvement of at least one lymph node in six patients (14%). Multivariate Cox proportional hazard regression analysis of seven clinicopathological variables showed that lymph node metastasis around the middle to lower greater curvature, or parapyloric area was the only significant independent unfavorable factor (odds ratio=6.62; 95% confidence interval=1.27-41.1; p=0.03) for survival. We identified no significant predictors of lymph node metastasis in analyzed patients.

Conclusion: From an oncological point of view, we do not recommend routine gastric tube reconstruction for Siewert type II carcinoma.

Keywords: Esophagogastric junction carcinoma; Siewert type II; gastric tube reconstruction.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery*
  • Female
  • Gastrectomy
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Plastic Surgery Procedures
  • Proportional Hazards Models
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*