Fukuchi Minoru, Mochiki Erito, Suzuki Okihide, Ishiguro Toru, Sobajima Jun, Onozawa Hisashi, Imaizumi Hideko, Shibata Kazue, Saito Kana, Naitoh Hiroshi, Kumagai Youichi, Ishibashi Keiichiro, Ishida Hideyuki
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan Department of Surgery, Gunma Chuo Hospital, Gunma, Japan
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Anticancer Res. 2015 Jan;35(1):505-9.
To evaluate the recurrence risk for Siewert type II esophagogastric junction carcinoma treated with curative resection.
We retrospectively analyzed clinicopathological and recurrence-free survival (RFS) data of 52 patients after curative resection for Siewert type II carcinoma focusing on the role of lymph node metastasis around the greater curvature or parapyloric area.
Recurrence was observed in 21 (40%) patients; the median time-to-recurrence was 11 months (range=3-33 months). According to multivariate Cox proportional hazard regression analysis, involvement of nodes no. 4sa, 4sb, 4d, 5 and/or 6 (odds ratio (OR)=6.62; 95% confidence interval (CI)=1.27-41.1; p=0.04) and younger age (OR=2.10; 95% CI=1.25-3.82; p<0.01) were significant independent risk factors affecting RFS.
Involvement of no. 4-6 nodes appears to predict recurrence of Siewert type II carcinoma treated with curative resection. Patients with this risk factor may benefit from effective use of perioperative chemotherapy.
评估接受根治性切除的Siewert II型食管胃交界癌的复发风险。
我们回顾性分析了52例接受Siewert II型癌根治性切除术后患者的临床病理及无复发生存（RFS）数据，重点关注大弯侧或幽门旁区域淋巴结转移的作用。
21例（40%）患者出现复发；复发的中位时间为11个月（范围=3 - 33个月）。根据多因素Cox比例风险回归分析，第4sa、4sb、4d、5和/或6组淋巴结受累（比值比（OR）=6.62；95%置信区间（CI）=1.27 - 41.1；p = 0.04）以及较年轻的年龄（OR = 2.10；95% CI = 1.25 - 3.82；p < 0.01）是影响RFS的显著独立危险因素。
第4 - 6组淋巴结受累似乎可预测接受根治性切除的Siewert II型癌的复发。具有该危险因素的患者可能受益于围手术期化疗的有效应用。
