Abstract
Objectives:We looked at risk factors and patterns of recurrence following surgical treatment of Gastro-Oesophageal Junction carcinoma (GOJC).Methods:Electronic medical records of patients with GOJC undergoing resection with curative intent between Jan 2009 and June 2017 at Shaukat Khanum Memorial Cancer Hospital were reviewed. GOJ cancer was classified as per Siewert classification. Clinical and operative details were studied and data was analysed using SPSS 20.Results:During the study period, we identified 78 patients with GOJ adenocarcinoma (38 patients with GOJ Type-I, 16 with Type-II tumors and 24 patients with GOJ Type-III tumors). Median age was 56 years ± 1.1. Male to female distribution was 72 versus 28%. Carbo-Pacli /5-FU based XRT verses Magic protocol (p<0.015) and advanced pathological T.-stage (p-value<0.032) were found to be statistically significant risk factors for recurrence. After a median follow up of 17.8 months+/- 1.5, 20 patients developed recurrence of which five had local recurrence, three had regional recurrence, eight had distant metastases and four had both local and distant metastases.Conclusion:The incidence of recurrence following curative resection of GOJC is 25%. Type of neoadjuvant treatment, waiting time for surgery and advanced T-stage are a risk factor for recurrence.
Highlights
Esophageal and gastric cancers are among eight major cancers that account for 60% of the global cancer burden regarding incidence and mortality.[1]
Siewert and Stein proposed a topographical classification of gastroesophageal junction (GOJ) adenocarcinoma in 1996
We present a retrospective review of patients diagnosed with GOJ adenocarcinoma and treated with neo adjuvant therapy followed by complete resection during 8-year study period, at a single cancer center in Pakistan
Summary
Esophageal and gastric cancers are among eight major cancers that account for 60% of the global cancer burden regarding incidence and mortality.[1] Incidence of adenocarcinoma of gastroesophageal junction (GOJ) is rising specially in Western world despite decrease in esophageal squamous cell carcinoma and gastric adenocarcinoma. This increase is mainly due to increase in prevalence of obesity.[2] This is expected to happen in the Eastern countries in the near future due to Westernization.[3]. GOJ Type-I tumor is located between 1 and 5 cm
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