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Treatment of the Adenocarcinoma of the Esophagogastric Junction at a Single Institution in Mexico

  • Thoracic
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

ABSTRACT

Background

Adenocarcinoma of the esophagogastric junction (EGJ) is rapidly increasing in the west. Our aim is to define the prognostic factors and treatment of EGJ carcinoma in Mexico, particularly the location after the Siewert’s classification.

Methods

A retrospective cohort of patients suffering from EGJ adenocarcinoma treated from 1987 to 2000. The Kaplan-Meier and the Cox’s models were used to define prognostic factors.

Results

Two hundred and thirty-four patients were included, 90 females and 144 males. Surgical resection was possible in 68 cases only (29%). Significant prognostic factors were tumor node metastasis (TNM) stage [stages I–II: risk ratio (RR) is 1; stage III RR is 1.3, 95% confidence interval (CI) 0.75–2.4; stage IV RR, 2.04, 95% CI 1.1–3.7], gender (male RR = 1.47, 95% CI 1.05–2.05), metastatic lymph node ratio (no resection: RR = 1; ratio 0.2–1 RR=0.67, 95% CI 0.39–1.14; ratio 0–0.19 RR = 0.42, 95% CI 0.23–0.76) and seralbumin (3 mg/dL or less RR = 2.05 95% CI 1.3–3.2; 3.1–3.4 mg/dL RR = 1.9 95% CI 1.2–3.03; 3.5–3.8 mg/dL RR = 1.3 95% CI 0.8–1.9; 3.9 mg/dL or more: RR = 1) (model P = 0.0001).

Conclusions

EGJ adenocarcinoma is a highly lethal neoplasia and the location after the Siewert’ classification is not a prognostic factor. In Mexico, TNM clinical stage, serum albumin, gender, surgical resection and metastatic lymph node ratio are significant prognostic factors. Curative treatment is infrequent but radical resection is associated to longer survival. Consequently, the management must consider quality of life and surgical morbidity.

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Acknowledgments

Many thanks to Ms Blanca Rosas Rosas and to Maria Esther Briones Trejo for their invaluable help with the logistics of this research. Many thanks also to Alejandra García Hubard for her help in the writing of the manuscript and to Maggie Brunner, M.A. for her English language editorial review.

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Authors and Affiliations

  1. Clínica de Neoplasias Gástricas, Gastroenterology Department, Surgery Division, Instituto Nacional de Cancerología, México D.F., México

    Luis F. Oñate-Ocaña MD, Gonzalo Milán-Revollo MD, Vincenzo Aiello-Crocifoglio MD & José F. Carrillo MD

  2. Medical Oncology Department, Internal Medicine Division, Instituto Nacional de Cancerología, México D.F., México

    Dolores Gallardo-Rincón MD

  3. Tomography, Ultrasound and Magnetic Resonance Department, Instituto Nacional de Cancerología, México D.F., México

    Rocío Brom-Valladares MD, MPH

  4. Pathology Department, Instituto Nacional de Cancerología, México D.F., México

    Roberto Herrera-Goepfert MD

  5. Unidad de Investigación Biomédica en Cancer, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Instituto Nacional de Cancerología, México D.F., México

    Alfonso Dueñas-González MD, PhD

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  1. Luis F. Oñate-Ocaña MD
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  2. Gonzalo Milán-Revollo MD
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  3. Vincenzo Aiello-Crocifoglio MD
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Correspondence to Luis F. Oñate-Ocaña MD.

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Oñate-Ocaña, L.F., Milán-Revollo, G., Aiello-Crocifoglio, V. et al. Treatment of the Adenocarcinoma of the Esophagogastric Junction at a Single Institution in Mexico. Ann Surg Oncol 14, 1439–1448 (2007). https://doi.org/10.1245/s10434-006-9216-4

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  • DOI: https://doi.org/10.1245/s10434-006-9216-4

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