Liu Xin, Jiang Qingtao, Yue Chao, Wang Qin
Department of Prevention and Control for Occupational Disease, Jiangsu Provincial Center for Disease Control and Prevention & Jiangsu Preventive Medicine Association, Nanjing, People's Republic of China.
Department of Clinical Medicine, Jiangsu Health Vocational College, Nanjing, People's Republic of China.
Int J Gen Med. 2021 Dec 24;14:10303-10314. doi: 10.2147/IJGM.S341405. eCollection 2021.
Adenocarcinoma of the esophagogastric junction (AEJ) is a relatively rare malignancy in Western countries whose specific clinicopathological characteristics and associated prognosis have not been comprehensively described.
Data on patients with AEJ between 2005 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were extracted, evaluated, and compared with patients with gastric cancer (GC) in general. Overall survival (OS) was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards regression model to identify risk factors predictive for OS, and the results were used to construct a nomogram to predict 1-, 3-, and 5-year OS among patients with AEJ.
A total of 8013 patients diagnosed with AEJ were identified from the records of 30,179 patients with GC. The mean age was 65.4 (SD = 12.0) years, 79.5% were men, 87.2% were Caucasian, 91.5% were moderately-to-poorly differentiated, 34.4% had AJCC stage I AEJ, and 28.8% had stage IV. The median OS was 18 months, and the 5-year OS was 25.8% (95% CI: 24.8-26.8%). Fewer patients with AEJ had undergone surgical resection, fewer had T+ and N+ (N2~N3) disease ( < 0.001), and fewer had distant metastases compared to the patients with GC ( < 0.05). In the univariate and multivariate analyses, age, race, summary stage, N stage, M stage, and surgery were identified as independent risk factors. The nomogram had a calibration index of 0.726.
AEJ was found to have distinct clinicopathological characteristics. Age, race, summary stage, N stage, M stage, and surgery were independently associated with OS. The nomogram accurately predicted 1-, 3-, and 5-year OS rates.
食管胃交界腺癌（AEJ）在西方国家是一种相对罕见的恶性肿瘤，其具体的临床病理特征及相关预后尚未得到全面描述。
提取、评估监测、流行病学和最终结果（SEER）数据库中2005年至2015年AEJ患者的数据，并与一般胃癌（GC）患者的数据进行比较。采用Kaplan-Meier法评估总生存期（OS）。使用Cox比例风险回归模型进行单因素和多因素分析，以确定预测OS的危险因素，并将结果用于构建列线图，以预测AEJ患者1年、3年和5年的OS。
从30179例GC患者记录中确定了8013例诊断为AEJ的患者。平均年龄为65.4（标准差=12.0）岁，79.5%为男性，87.2%为白种人，91.5%为中低分化，34.4%为AJCC I期AEJ，28.8%为IV期。中位OS为18个月，5年OS为25.8%（95%CI：24.8-26.8%）。与GC患者相比，接受手术切除的AEJ患者更少，T+和N+（N2~N3）疾病患者更少（<0.001），远处转移患者更少（<0.05）。在单因素和多因素分析中，年龄、种族、总分期、N分期、M分期和手术被确定为独立危险因素。列线图的校准指数为0.726。
发现AEJ具有独特的临床病理特征。年龄、种族、总分期、N分期、M分期和手术与OS独立相关。列线图准确预测了1年、3年和5年的OS率。
