High-risk group of upper and middle mediastinal lymph node metastasis in patients with esophagogastric junction carcinoma

Masahiro Yura, Hiroya Takeuchi, Kazumasa Fukuda, Rieko Nakamura, Koichi Suda, Norihito Wada, Hirofumi Kawakubo, Yuko Kitagawa

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim: The aim of the present study was to clarify esophagogastric junction (EGJ) carcinoma patients who are at high risk of upper and middle mediastinal lymph node (MLN) metastasis. Methods: This was a retrospective study and included 110 consecutive patients with EGJ carcinoma who underwent R0/R1 resection at Keio University Hospital between January 2000 and December 2013. Results: Of the 110 patients, 18 (16.3%) had MLN metastasis, and the number increased to 23 (20.9%) when recurrence cases were added (adenocarcinoma, N = 11; squamous cell carcinoma, N = 12). Patients whose tumor epicenter was located above the EGJ had a significantly higher incidence of MLN metastasis/recurrence (18/51 [35.3%]) than those whose tumor epicenter was located below the EGJ (5/59 [8.5%]). The MLN metastasis/recurrence rate was particularly high when the distance from the EGJ to the proximal edge of the primary tumor was >3 cm for the upper and middle mediastinum (18.8%). Patients in a selected group (≥T2 and tumor epicenter located above the EGJ or below the EGJ with ≥3 cm esophageal invasion) showed 17.9% and 15.4% upper and middle MLN metastasis/recurrence rates, respectively. Therapeutic value of MLN dissection was relatively high (#105 + 106: 8.9, #110: 12.2). Conclusions: Therapeutic value of MLN dissection to treat EGJ carcinomas was relatively high in patients with MLN metastasis. Our algorithm could select patients at high risk for MLN metastasis.

Original languageEnglish
Pages (from-to)419-427
Number of pages9
JournalAnnals of Gastroenterological Surgery
Volume2
Issue number6
DOIs
Publication statusPublished - 11-2018

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Surgery

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