PS01.194: CLINICOPATHOLOGICAL EXAMINATION OF ESOPHAGOGASTRIC JUNCTIONAL CARCINOMA TREATED WITH CURATIVE SURGERY

Abstract

Abstract Background Compared to Western countries, Japanese esophagogastric junctional carcinoma (JC) demonstrates different epidemiologic backgrounds; squamous cell carcinoma is dominant over Barrett adenocarcinoma, and there is no consensus on surgical approach or dissection range of lymph node. JC is defined as the cancer, that is the center of the tumor is within 2 cm from the esophagogastric junction to the esophagus and stomach respectively by the Japanese Classification of Esophageal Cancer, 11th edition. According to this definition, we examined the clinicopathological features and treatment outcomes of patients who underwent curative resection and pathologically defined as JC. Methods From 2012 to 2018, 19 consecutive patients with JC who received with curative surgery in Shiga University of Medical Science Hospital were included. Clinicopathological classification was based on Japanese Classification of Esophageal Cancer, 11th edition. Results The patients consisted of 14 males and 5 females, median age was 68 (43–91) years old. Pathological diagnoses were 15 adenocarcinoma, 1 squamous cell carcinoma, 2 mixed adenoneuroendocrine carcinoma (MANEC) and 1 malignant melanoma. Patients with Barrett's esophagus were 6 cases (31.6%). Median tumor diameter was 54 mm (5–90 mm) and tumor location was E:3 cases (15.8%), EG:6 cases (31.6%), E = G:1 case (5.2%), GE:8 cases (42.1%) and G:1 case (5.2%). Surgical procedure was esophagectomy via right thoracotomy 6 cases, esophagectomy via left thoracotomy 2 case and laparotomy 11 cases. Tumor invasion was pT1:6 (31.6%), pT2:3 (15.8%), pT3:3 (15.8%) and pT4:7 (36.8%). Lymph node metastases were observed in 13 cases (68.4%) and #1,2,3:13 cases (100%), #4,5: 2 cases (15.4%), #7,8a,9: 4 cases (30.8%), #19,20: 3 cases (23.1%) and #105–110: 3 cases (23.1%). Among 7 recurrence patients, peritonitis carcinomatosa was 4 cases. Conclusion In all positive lymph node metastasis cases, metastasis was observed in #1, 2 and 3 lymph nodes, but metastasis to the cervical lymph node was not observed. In the G, GE cases, right thoracotomy was not performed because there were no metastases to the upper mediastinal lymph nodes. In conclusion, these results suggested that surgical operation could be reduced to proximal gastrectomy for early G, GE cases. However, the number of cases is small in this study, further investigation is necessary. Disclosure All authors have declared no conflicts of interest.