Lymph node metastasis from cancer of the esophagogastric junction, and determination of the appropriate nodal dissection
- 14 January 2012
- journal article
- Published by Springer Science and Business Media LLC in Surgery Today
- Vol. 42 (4), 351-358
- https://doi.org/10.1007/s00595-011-0114-4
Abstract
Both squamous cell carcinomas and adenocarcinomas can develop in the esophagogastric junction. To clarify the appropriate lymph node dissection range, lymph node metastases from cancers in the esophagogastric junction were investigated. The nodal metastases were analyzed in 64 patients with squamous cell carcinoma and 129 with adenocarcinoma according to Siewert’s classification, which is based on topographic anatomical criteria for adenocarcinoma. The squamous cell carcinomas located above the esophagocardial junction had more frequent metastasis to the lower and middle mediastinal lymph nodes in proportion to the depth of the tumor. Nodal metastasis was also often detected in the abdominal lymph nodes. In contrast, adenocarcinomas metastasized less frequently to the mediastinal lymph nodes, and the metastatic rates in the abdominal nodes were higher than those from squamous cell carcinoma. Esophagectomy with mediastinal and abdominal lymph node dissection is considered to be an appropriate approach for surgical resection of squamous cell carcinomas, whereas transhiatally extended gastrectomy with lower mediastinal and abdominal lymph node dissection is recommended for the treatment of adenocarcinomas.Keywords
This publication has 24 references indexed in Scilit:
- Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategiesGastric Cancer, 2010
- The possibility of performing a limited resection and a lymphadenectomy for proximal gastric carcinoma based on sentinel node navigationSurgery Today, 2009
- Advances in esophageal cancer surgery in Japan: An analysis of 1000 consecutive patients treated at a single instituteSurgery, 2008
- Are Squamous and Adenocarcinomas of the Esophagus the Same Disease?Seminars in Radiation Oncology, 2006
- Epidemiology of esophageal adenocarcinomaJournal of Surgical Oncology, 2005
- Early Esophageal CancerAnnals of Surgery, 2005
- The Role of Overdiagnosis and Reclassification in the Marked Increase of Esophageal Adenocarcinoma IncidenceJNCI Journal of the National Cancer Institute, 2005
- No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancerBritish Journal of Surgery, 1999
- Classification of adenocarcinoma of the oesophagogastric junctionBritish Journal of Surgery, 1998
- Lymph Node Metastasis of Early Stage Carcinoma of the Esophagus and of the StomachJournal of Clinical Gastroenterology, 1995