Patients with esophageal adenocarcinoma showed better prognosis than those with adenocarcinoma of the gastroesophageal junction

被引:4
作者
Huang, Qin [1 ,2 ,9 ,10 ]
Cheng, Yuqing [3 ,4 ]
Lew, Edward [5 ]
Shi, Jiong [6 ]
Wiener, Daniel [7 ]
Weber, H. Christian [8 ]
机构
[1] Beth Israel Deaconess Med Ctr, Dept Pathol, Boston, MA USA
[2] Harvard Med Sch, Boston, MA USA
[3] Vet Affairs Boston Healthcare Syst, Previously Dept Pathol & Lab Med, West Roxbury, MA USA
[4] Nanjing Med Univ, Dept Pathol, Affiliated Changzhou 2 Peoples Hosp, Changzhou, Jiangsu, Peoples R China
[5] Harvard Med Sch, Brigham & Womens Hosp, Dept Gastroenterol, Vet Affairs Boston Healthcare Syst, West Roxbury, MA USA
[6] Nanjing Univ, Dept Pathol, Nanjing Drum Tower Hosp, Med Sch, Nanjing, Jiangsu, Peoples R China
[7] Harvard Med Sch, Brigham & Womens Hosp, Dept Thorac Surg, Vet Affairs Boston Healthcare Syst, West Roxbury, MA USA
[8] Boston Univ, Dept Gastroenterol, Vet Affairs Boston Healthcare Syst, Sch Med, Boston, MA USA
[9] Beth Israel Deaconess Med Ctr, Dept Pathol, 330 Brookline Ave, Boston, MA 02215 USA
[10] Harvard Med Sch, 330 Brookline Ave, Boston, MA 02215 USA
关键词
adenocarcinoma of esophagus; adenocarcinoma of gastroesophageal junction; Barrett esophagus; esophagus; stomach; PROXIMAL GASTRIC-CARCINOMA; ESOPHAGOGASTRIC JUNCTION; BARRETTS-ESOPHAGUS; DISTAL ESOPHAGUS; RISK-FACTORS; CANCER; CARDIA; SURVIVAL; CHINESE; TUMORS;
D O I
10.1111/1751-2980.13167
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives: We followed The Cancer Genome Atlas (TCGA) grouping criteria and conducted a clinicopathological cohort study in a unique patient population to gain insight into the pathobiology of esophageal adenocarcinoma (EAC) and adenocarcinoma of the gastroesophageal junction (AGEJ).Methods: We studied and statistically compared the clinicopathological and prognostic features of both cancers in 303 consecutive patients treated at the Veterans Affairs Boston Healthcare System over a 20-year period using uniform criteria and standardized routines.Results: Over 99% of patients were white men with a mean age of 69.1 years and an average body mass index (BMI) of 28.0 kg/m(2). No significant differences were detected in age, gender, ethnicity, BMI, and history of tobacco abuse between the two groups. Compared to AGEJ patients, a significantly higher proportion of EAC patients had gastroesophageal reflux disease, long-segment Barrett's esophagus, common adenocarcinoma type, smaller tumor size, better differentiation, more stages I or II but fewer stages III or IV diseases, scarcer lymph node invasion, fewer distant metastases, and better overall, disease-free, and relapse-free survival. The 5-year overall survival rate was significantly higher in EAC patients than in AGEJ patients (41.3% vs 17.2%, P < 0.001). This improved survival among EAC patients remained significant after censoring all cases detected during endoscopic surveillance, suggesting different pathogenesis mechanisms between EAC and AGEJ.Conclusions: EAC patients showed significantly better outcomes than AGEJ patients. Our results require validation in other patient populations.
引用
收藏
页码:98 / 112
页数:15
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