Transthoracic esophagectomy of adenocarcinoma in Barrett’s esophagus in Japanese patients: analysis of localization of lymph node metastases in 19 cases View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-09-22

AUTHORS

Yoshimi Iwanuma, Natsumi Tomita, Takayuki Amano, Fuyumi Isayama, Masahiko Tsurumaru, Yoshiaki Kajiyama

ABSTRACT

BackgroundThe incidence of esophageal adenocarcinoma is only 1%–2% in Japan. For this reason, many aspects of this disease have not been clarified, such as its generation, progress, and the potential of malignancy. It is necessary to investigate the strategy for treating this disease.MethodsBetween 1998 and 2008, 19 cases were diagnosed as adenocarcinoma with Barrett’s esophagus and treated with esophagectomy at Juntendo University: 13 cases were early stage and 6 cases were advanced stage. Distribution of lymph node metastasis and prognosis were investigated.ResultsThe incidence of lymph node metastases of adenocarcinoma is statistically lower (15.4%) compared with that of squamous cell carcinoma (SCC) (44.0%) (P = 0.034) when the depth of the tumor is not beyond the submucosal layer. Even in the early stages of adenocarcinoma, positive nodes were found in the lower mediastinum and gastric cardia. In advanced cases, cancer had spread randomly to the upper mediastinum or celiac region. Mean survival time of superficial and advanced adenocarcinoma after esophagectomy was 3,517.5 ± 330.6 and 2,061.4 ± 451.3 days, respectively, whereas that of SCC was 2,794.7 ± 131.0 and 1,669.1 ± 101.5 days, respectively. Overall survival of superficial or advanced adenocarcinoma was better than that of SCC but was not statistically superior.ConclusionsEndoscopic mucosal resection is limitedly proposed for mucosal tumors. Esophagectomy with a mediastinal lymphadenectomy should be conducted for tumors invading the submucosa. An individualized strategy is required that could approach the upper mediastinum based on staging and location of lymph node metastases. More... »

PAGES

137-141

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10388-010-0237-5

DOI

http://dx.doi.org/10.1007/s10388-010-0237-5

DIMENSIONS

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188 rdf:type schema:Organization
189 grid-institutes:grid.258269.2 schema:alternateName Department of Esophageal & Gastroenterological Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
190 schema:name Department of Esophageal & Gastroenterological Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
191 rdf:type schema:Organization
 




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