Pattern of nodal recurrence after curative resection in Siewert II and III locally advanced adenocarcinoma of gastroesophageal junction

• DOI: 10.3760/cma.j.issn.1004-4221.2016.04.011
• Publication Date: 2016-04-15
• Authors: Jiajia Zhang; Zhenwei Liang; Ying Li; Xin Wang; Yuan Tang; Tongtong Liu; Yanru Feng; Ning Li; Jing Yu; Shuai Li; Hua Ren; Shuangmei Zou; Jun Jiang; Wei Han; Weihu Wang; Shulian Wang; Yong-Wen Song; Yueping Liu; Hui Fang; Xin-Fan Liu; Zi-hao Yu; Ye‐Xiong Li; Liming Jiang; Jing Jin
• Keywords: T-stage

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma gastroesophageal junction (AGE), and to provide a basis for delineation radiation range high-risk lymphatic drainage area.

Methods A retrospective analysis was performed 78 patients with locally advanced AGE who were newly treated our hospital from January 2009 December 2013 had complete clinical data. All received pathologically diagnosed stage T3/T4 or N (+) AGE. Those also Siewert Ⅱ Ⅲ by endoscopy, upper gastroenterography, macroscopic examination during operation, pathological specimens. None preoperative postoperative radiotherapy. imaging recurrence. The computed tomography images those accessible all sites clearly fully displayed.

Results The median time 10 months (1-48 months), 90% occurred within 2 years surgery. lymph nodes highest risk No.16b1(39%), No.16a2(37%), No.9(30%), No.11p (26%), respectively. There no significant difference rate each area between (P=0.090-1.000). most frequent No.16b1, No.16a2, No.9, No.16b2, No.11p, No.7 N3 No.8, non-N3 Patients significantly higher para-aortic regions (No.16a2-b2) than (67% vs. 33%, P=0.004, OR=4.00, 95% CI=1.54-10.37).

Conclusions The are located celiac artery, proximal splenic retroperitoneal areas (No.16a2 No.16b1) AEG. Moreover, have above should be involved target volume radiotherapy.

Key words: Cancer, junction/surgery; Nodal recurrence; Target