Tumor size predicts worse prognosis in esophagogastric junction adenocarcinoma

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTAKEDA, Flavio Roberto
dc.contributor.authorRAMOS, Marcus Fernando Kodama Pertille
dc.contributor.authorPEREIRA, Marina Alessandra
dc.contributor.authorSALLUM, Rubens Antonio Aissar
dc.contributor.authorRIBEIRO JUNIOR, Ulysses
dc.contributor.authorNAHAS, Sergio Carlos
dc.contributor.authorCECCONELLO, Ivan
dc.date.accessioned2022-12-21T13:21:49Z
dc.date.available2022-12-21T13:21:49Z
dc.date.issued2022
dc.description.abstractAdenocarcinoma of the esophagogastric junction (AEGJ) has an increasing incidence and is associated with limited overall survival. Several studies have tried to identify prognostic factors for AEGJ, although few have described relationships between prognosis and the tumor's size or anatomical location. Thus, this retrospective study evaluated 188 patients with resected locally advanced AEGJ. Tumor location was determined using upper endoscopy, and the following groups were created: E&E + EGJ (distal esophagus, esophagogastric junction, and distal esophagus), EGJ (esophagogastric junction), EGJ + G (esophagogastric junction and proximal stomach), G (proximal stomach), and E + EGJ + G (esophagus to the proximal stomach, including the esophagogastric junction). Other variables of interest were tumor size and differentiation, TNM stage, comorbidities, surgery type, and survival outcomes. Among 188 patients included, 163 were men (86.7%), and the mean age was 64.9 years. Forty-eight (25.6%) patients underwent total gastrectomy and distal esophagectomy, while 140 (74.4%) subtotal esophagectomy with proximal gastrectomy. Presence of comorbidities, tumor size, angiolymphatic and perineural invasion, and pTNM status were different between groups according to tumor location. The mean follow-up period was 47.4 months. The disease-free survival (DFS) rates were as follows: 72.7% (G), 68.0% (E&E + EGJ), 63.4% (EGJ), 57.1% (EGJ + G), and 44.4% (E + EGJ + G), while the overall survival (OS) rates were 81.0% (EGJ + G), 78.8% (G), 64.0% (E&E + EGJ), 54.9% (EGJ), and 48.1% (E + EGJ + G). Multivariate analysis revealed that tumor size of < 5 cm, and tumor location G subgroups were associated with better DFS. High histological grade and advanced pT status were independent factors related to worse OS. In conclusion, the prognosis of AEGJ may be preoperatively predicted by a tumor size of >= 5 cm and its anatomical location.eng
dc.description.indexMEDLINEeng
dc.identifier.citationUPDATES IN SURGERY, v.74, n.6, p.1871-1879, 2022
dc.identifier.doi10.1007/s13304-022-01313-6
dc.identifier.eissn2038-3312
dc.identifier.issn2038-131X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/50504
dc.language.isoeng
dc.publisherSPRINGER-VERLAG ITALIA SRLeng
dc.relation.ispartofUpdates in Surgery
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGER-VERLAG ITALIA SRLeng
dc.subjectEsophagogastric junction adenocarcinomaeng
dc.subjectTumor sizeeng
dc.subjectPrognostic factorseng
dc.subjectSiewert classificationeng
dc.subjectSurgical treatmenteng
dc.subject.otherchemoradiotherapyeng
dc.subject.otheresophagealeng
dc.subject.otherresectioneng
dc.subject.othercancereng
dc.subject.wosSurgeryeng
dc.titleTumor size predicts worse prognosis in esophagogastric junction adenocarcinomaeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus3
hcfmusp.contributor.author-fmusphcFLAVIO ROBERTO TAKEDA
hcfmusp.contributor.author-fmusphcMARCUS FERNANDO KODAMA PERTILLE RAMOS
hcfmusp.contributor.author-fmusphcMARINA ALESSANDRA PEREIRA
hcfmusp.contributor.author-fmusphcRUBENS ANTONIO AISSAR SALLUM
hcfmusp.contributor.author-fmusphcULYSSES RIBEIRO JUNIOR
hcfmusp.contributor.author-fmusphcSERGIO CARLOS NAHAS
hcfmusp.contributor.author-fmusphcIVAN CECCONELLO
hcfmusp.description.beginpage1871
hcfmusp.description.endpage1879
hcfmusp.description.issue6
hcfmusp.description.volume74
hcfmusp.origemWOS
hcfmusp.origem.pubmed35776245
hcfmusp.origem.scopus2-s2.0-85133223398
hcfmusp.origem.wosWOS:000819724900001
hcfmusp.publisher.cityMILANeng
hcfmusp.publisher.countryITALYeng
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hcfmusp.scopus.lastupdate2024-05-10
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Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
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