Cardiac Cancer Research Articles

RA08.03: LYMPH NODE METASTASIS RISK IN SUPERFICIAL ESOPHAGOGASTRIC JUNCTIONAL ADENOCARCINOMA

Abstract Background We have reported that lymph node metastasis risk in cases of superficial Barrett's esophageal cancer (BC) was of submucosal invasion within 500μm without other risk factors (lymphovascular involvement, a poorly differentiated component, and lesion size) through a multicenter retrospective study in 13 facilities. Cardiac cancer (CC) was included in the gastric cancer criteria of the Japanese Gastric Cancer Association. Since BC and CC near the esophagogastric junction (EGJ) show almost the same biological behavior, we elucidated the metastasis risk factors in patients with EGJ adenocarcinoma. Methods Patients who underwent ESD for superficial EGJ adenocarcinoma as Siewert typeII between January 2011 and April 2017 were included. Results A total of 120 patients were analyzed. Fifty-three patients (44.1%) had BC and 67 patients (55.8%) had CC. Of the 120 lesions, the median size was 16.7 ± 8.5 mm; 10 (8.3%; 4 BC, 6 CC) were greater than 30 mm in size. Thirty-five (29.1%; 17 BC, 18 CC) were submucosal (SM) cancers. Twenty-one (17.5%; 13 BC, 8 CC) had poorly differentiated components and 19 (15.8%; 14 BC, 5 CC) had lymphovascular involvement. Of the 19 cases with lymphovascular involvement, 11/22 (50%) were SM cancers with > 200μm of invasion, and 8/98 (8.1%) were mucosal (M)/SM cancers within SM200μm of invasion. Of the BCs with DMM invasion, 7/17 (41.1%) had lymphovascular involvement. Of the patients initially treated through ESD, 33 (27.5%) had lymphovascular involvement, positive horizontal/vertical margins, or SM > 200μm of invasion. Of these, 26 were treated with additional surgery. Metastasis was confirmed from 2 patients. Both were BCs, with SM > 501μm of invasion, positive lymphovascular involvement, and with poorly differentiated components. One was > 30 mm in size. Metastasis was not identified in CC and in cases with SM < 200μm of invasion. Conclusion For superficial esophagogastric cancer, we did not identify metastasis in patients with SM > 501 μm of invasion. There were no cases of metastasis in patients without risk factors. ESD might be indicated for lesions within SM 500μm of invasion without risk factors. Among DMM cases of BC, lymphovascular involvement was highly frequent. Therefore, histopathological surveillance for lymphovascular involvement is important. Disclosure All authors have declared no conflicts of interest.

Temporal trends of esophageal cancer during 1995–2004 in Nanao Island, an extremely high-risk area in China

The purpose of our study was to investigate the temporal malignant tumor incidence rates among the 70,000 residents at the relatively isolated Nanao Island in South China Sea. The data on all malignant tumor cases from Nanao Cancer Registry during 1995-2004 were coded, computerized, and analyzed using the software SPSS10.0. The tumor incident cases, crude incident rate, age-standardized incidence rate, their sex distribution and temporal trend were assessed. A total of 1450 new cancer cases (990 males and 460 females) were identified. The annual average age-standardized incidence rate (ASR) of malignant tumors was 208.18/100,000. The age-standardized incidence rate of the ten leading cancers in both sexes combined per 100,000 population were 74.47 for esophageal cancer (EC), 34.81 for cardiac cancer (CC), 25.66 for liver cancer, 26.01 for lung cancer, 18.52 for stomach cancer, 4.45 for nasopharyngeal cancer, 3.91 for breast cancer, 2.53 for colon/rectum cancer, 2.45 for bladder cancer and 1.92 for pancreatic cancer. These ten types of cancers make up to 93% of all cancer cases, with EC and CC being the most prevalent and making up 52% of the total cases. The incidence rates of esophagus, liver, lung, breast, nasopharyngeal, and colon/rectum cancers showed increasing trends during the period from 1995 to 2004 in Nanao Island. Astounding the EC ASR were 72-150/100,000 among male and 26-64/100,000 among female in Nanao Island during 1995-2004. The EC incidence rate in Nanao population is among the highest across the world, which suggests that there are potential genetic and/or environmental factors affecting this particular population.

Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China.

To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the past has made Chaoshan a relatively closed area and kept its culture and custure of old China thousand years ago. Data on age, sex, ABO blood type and X-ray or pathological diagnose of the patients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 patients with esophageal carcinoma (EC) and 2955 patients with cardiac cancer (CC) in Chaoshan district were retrospectively assessed for their association with ABO blood groups. The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, blood group B in male patients with CC and in the patients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B O was 1.1415 (P<0.05) and 1.2696 (P<0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation. ABO blood group B is associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.