Batool Sadaf, Khan Misbah, Akbar Sana Amir, Ashraf Ijaz
Sadaf Batool, MRCS. FCPS Trainee, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Misbah Khan, FCPS. Fellow European Board of Surgical Oncology, Fellow Surgical Oncology, Senior Instructor Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, MRCS. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Pak J Med Sci. 2019 Sep-Oct;35(5):1276-1283. doi: 10.12669/pjms.35.5.963.
We looked at risk factors and patterns of recurrence following surgical treatment of Gastro-Oesophageal Junction carcinoma (GOJC).
Electronic medical records of patients with GOJC undergoing resection with curative intent between Jan 2009 and June 2017 at Shaukat Khanum Memorial Cancer Hospital were reviewed. GOJ cancer was classified as per Siewert classification. Clinical and operative details were studied and data was analysed using SPSS 20.
During the study period, we identified 78 patients with GOJ adenocarcinoma (38 patients with GOJ Type-I, 16 with Type-II tumors and 24 patients with GOJ Type-III tumors). Median age was 56 years ± 1.1. Male to female distribution was 72 versus 28%. Carbo-Pacli /5-FU based XRT verses Magic protocol (p<0.015) and advanced pathological T.-stage (p-value<0.032) were found to be statistically significant risk factors for recurrence. After a median follow up of 17.8 months+/- 1.5, 20 patients developed recurrence of which five had local recurrence, three had regional recurrence, eight had distant metastases and four had both local and distant metastases.
The incidence of recurrence following curative resection of GOJC is 25%. Type of neoadjuvant treatment, waiting time for surgery and advanced T-stage are a risk factor for recurrence.
我们研究了胃食管交界癌（GOJC）手术治疗后的危险因素及复发模式。
回顾了2009年1月至2017年6月在沙卡特汗姆纪念癌症医院接受根治性切除的GOJC患者的电子病历。GOJ癌根据Siewert分类法进行分类。研究临床和手术细节，并使用SPSS 20分析数据。
在研究期间，我们确定了78例GOJ腺癌患者（38例GOJ I型患者，16例II型肿瘤患者和24例GOJ III型肿瘤患者）。中位年龄为56岁±1.1。男女分布为72%对28%。发现基于卡铂-紫杉醇/5-氟尿嘧啶的放疗方案与Magic方案（p<0.015）以及晚期病理T分期（p值<0.032）是具有统计学意义的复发危险因素。中位随访17.8个月±1.5后，20例患者出现复发，其中5例为局部复发，3例为区域复发，8例为远处转移，4例为局部和远处转移。
GOJC根治性切除术后的复发率为25%。新辅助治疗类型、手术等待时间和晚期T分期是复发的危险因素。
