Abstract
BackgroundThe incidence of the esophagogastric junction cancer is growing rapidly. The purpose of this study is to clarify the outcome of the ratio between metastatic and examined lymph nodes in esophagogastric junction cancer patients with or without 7 examined lymph nodes.MethodsA total of 3,481 patients who underwent operation are identified from the Surveillance, Epidemiology, and End Results database. Different lymph nodes resected groups are analyzed to test the lymph nodes ratio factor.ResultsThere are 2522 patients with 7 or more lymph nodes resected and 959 patients with less than 7 lymph nodes resected. Lymph nodes ratio and lymph node involvement are independent prognostic factors. But the lymph nodes ratio categories have a better prognostic value than the lymph node involvement categories. Compared with lymph node involvement categories, lymph nodes ratio categories represent patients with more homogeneous overall survival rate.ConclusionsThis study defines that the lymph nodes ratio is an independent prognostic factor for esophagogastric junction cancer. The lymph nodes ratio can prevent stage migration and may be a helpful system to predict the prognosis of esophagogastric junction cancer patients.
Highlights
The incidence of the esophagogastric junction cancer (EGJC) is growing rapidly in Western countries
According to the anatomic cardia, Siewert defines that EGJC can be divided into three subtypes: type I, adenocarcinoma of the distal esophagus with the center located within 1 cm above and 5 cm above the anatomic esophagogastric junction (EGJ); type II, true carcinoma of the cardia with the tumor center within 1 cm above and 2 cm below the EGJ; type III, subcardial carcinoma with the tumor center between 2 cm and 5 cm below EGJ, which infiltrates the EGJ and distal esophagus from below [5]
If we remove the data which may result in the misleading, we can find that the maximum difference is 20% within the American Joint Committee on Cancer (AJCC) N2 category and 8% within the Lymph node ratio (LNR) 3 category. These results indicate that compared with AJCC N categories, LNR categories represent patients with more homogeneous overall survival rate
Summary
The incidence of the esophagogastric junction cancer (EGJC) is growing rapidly in Western countries. This trend has not occurred in Eastern countries [1,2,3,4]. The purpose of this study is to clarify the outcome of the ratio between metastatic and examined lymph nodes in esophagogastric junction cancer patients with or without 7 examined lymph nodes. Lymph nodes ratio and lymph node involvement are independent prognostic factors. Compared with lymph node involvement categories, lymph nodes ratio categories represent patients with more homogeneous overall survival rate. Conclusions: This study defines that the lymph nodes ratio is an independent prognostic factor for esophagogastric junction cancer. The lymph nodes ratio can prevent stage migration and may be a helpful system to predict the prognosis of esophagogastric junction cancer patients
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