Adenocarcinoma of the esophagogastric junction. Retrospective analysis of 39 patients

Background: The long term survival of adenocarcinoma of the esophagogastric junction is poor and depends on the possibility of performing a complete surgical excision and the absence of lymph node involvement. Aim: 716 report surgical results and Survival of patients with adenocarcinoma of the esophagograstric junction. Material and Methods: Retrospective review of medical records of patients with adenocarcinoma of the esophagogastric junction, subjected to a curative surgical procedure between 2000 and 2008. Deaths that occurred within 60 days of the operation were considered operative mortality Tumor stage was determination using TNM and Siewert pathological classifications. Results: Thirty nine patients aged 40 to 80 years (27 men), were operated. According to Siewert classification, seven patients had type 1, six type If and 26 type III tumors. Twenty two patients were subjected to a total gastrectomy), with Partial excision of distal esophagus and mediastinal reconstruction, 10 patients were subjected to a transhiatal esophagectomy and seven to a total esophagogastrectomy According to postoperative staging, five patients were in stage 1, 12 in stage 11, nine in stage III and 13 in stage IV Median, three and five years survival figures were 21.4 months, 33 and 25%, respectively Lymph node and perineural involvement was associated with a lower survival. Well differentiated and stage I tumors had a better survival. Multivariate analysis showed that the presence of a type III tumor, N3 lymph node involvement and vascular permeation were independent predictors of a lower survival. Conclusions:Among patients with adenocarcinoma of the esophagogastric Junction, type III tumors, lymph node involvement and vascular permeations ore associated with a lower survival. (Rev Med Chile 2010; 138: 53-60).