Moreover, AJCC defines

Moreover, AJCC defines selleckchem EGJ as including squamous-cell carcinoma in the same locations as with Siewert classification [4]. However Siewert classification is widely used, its application is limited for adenocarcinoma. Although EGJC, as defined by the AJCC cancer staging manual, includes squamous-cell carcinoma, it does not categorize any tumor without EGJ invasion as EGJC—as does Siewert classification. Although it estimates prognosis well using different staging systems for squamous-cell carcinoma and adenocarcinoma,

this method may be too complex for clinicians; whereas the JCEC system, which treats most limited LY2090314 mouse tumors as EGJC, is more precise. Because of the unstable definition of EGJCs, clinicopathological characters and treatment strategies have not been unified. Siewert et al. argued that complete surgical resection and lymph node metastasis were independent prognostic factors in type II adenocarcinoma, and subtotal esophagectomy had less survival effectiveness for the patients with type II adenocarcinoma [5]. Hasegawa et al. reported that about 40%, 60% and 90% of patients with type I, II and III tumors, respectively, had lymph node metastases, and recommended complete resection for improving survival [16]. Schiesser

et al. reported that subtotal esophagectomy and extended total gastrectomy should be performed for type I and type II–III tumor [17]. With regard to surgical approach, Sasako et al. showed that the left thoracoabdominal approach Androgen Receptor Antagonist did not improve survival after the abdominal-transhiatal approach and leads to increased morbidity in patients with cancer of the cardia or subcardia [18]. Kakeji et al. reported that esophagectomy with mediastinal and abdominal lymphadenectomy was adequate for squamous-cell carcinoma, and that extended total gastrectomy with lower mediastinal and abdominal lymphadenectomy was suitable for adenocarcinoma [19]. Carboni et al. maintained effects of extended gastrectomy by an abdominal–trans-hiatal approach for EGJC [20]. Conversely, Chau et al. reported that performance status, liver metastasis, peritoneal metastasis and alkaline phosphatase were independent prognostic factors in patients

with locally advanced and metastatic EGJC, and that prognoses of patients with recurrent disease were Bupivacaine no better than those without surgery [21]. We studied any tumor centered in area between the lowest 5 cm of the esophagus and the upper 5 cm of the stomach, regardless of histological type and EGJ invasion, and simply categorized them in 4 groups including type E (SQ), E (AD), Ge and G. Whereas type E (SQ), E (AD) and Ge tumors in this study are categorized as esophageal cancer by AJCC/UICC criteria, these tumor groups show differences in clinicopathological characteristics. In lymph node metastasis, approximately 60%, 50%, 70% and 30% of the patients with type E (SQ), E (AD), Ge and G tumors respectively had lymph node metastases in this study.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>