多模态时代食管胃结合部腺癌复发的预测因素。

Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era.

机构信息

Department of Gastroenterology, Digestive Surgery Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.

出版信息

Am J Surg. 2021 Mar;221(3):631-636. doi: 10.1016/j.amjsurg.2020.07.031. Epub 2020 Aug 22.

DOI:10.1016/j.amjsurg.2020.07.031

PMID:32862976

Abstract

INTRODUCTION

Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG.

METHODS

Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained.

RESULTS

We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028).

CONCLUSION

AEGJ is associated with high rates of early recurrence.

摘要

介绍

食管胃结合部腺癌（AEGJ）是一种预后较差的肿瘤。我们评估了通过 AEGJ 进行手术切除的患者中与复发相关的复发模式和危险因素。

方法

复发分为局部区域、腹膜和远处。将这三组复发组与非复发组进行比较，并获得每组的总生存（OS）和无病生存（DFS）。

结果

我们分析了 188 例接受根治性手术治疗的患者。72 例（38.3%）患者出现复发。局部区域复发 17 例（23.6%）；腹膜复发 20 例（27.8%）和远处转移 35 例（48.6%）。DFS 分别为 9、5 和 8 个月，OS 分别为 21.8、13.2 和 20.8。肿瘤大于 5cm 是腹膜复发的危险因素（OR：2.88，p=0.012）。阳性淋巴结与远处转移相关（OR：9.15，p=0.040），淋巴管浸润与局部区域复发相关（OR：3.81，p=0.028）。