28. Comparative study of pathological features and surgical outcomes of 116 patients with AEG according to the Siewert classification

Objective: The incidence of adenocarcinoma of esophagogastric junction (AEG) is rapidly rising in recent decades. This research retrospectively compared the clinicopathological features and surgical outcomes of patients with AEG according to the Siewert classification.
Methods: 116 cases of AEG in our hospital from March 2004 to July 2009 were divided into Siewert type II group (n=95) and Siewert type III group (n=21) according to the Siewert classification, and the clinicopathological characteristics,morbidity rates,survival rates and reoccurrence rates were comparatively studied.
Results: Compared to the Siewert type III group, Siewert type II group showed smaller tumor size (4.83+1.96 vs. 6.05+2.41 cm), shorter distance from the proximal esophageal surgical margin (1.14+0.8 vs. 1.63+1.11 cm), higher percentage of negative distal gastric resection margin and fewer perineural invasion, fewer amount of mean post lymph node (5.48±5.82 vs. 8.19±10.10). There were no significant differences in other factors. Univariate analysis showed that tumer size, metastasis and pathological lymph node stage were associated with overall survival rate. However, multivariate analysis did not identify any independent risk factor for postoperative survival. The 1-year. 2-year. 3-year. 5-year survival rates of Siewert type II group were similar to those of Siewert type III group (5.9% vs. 85.7%, P=0.287; 67.6% vs. 66.7%, P=0.368; 60% vs. 43.8%, P=0.326; 30% vs. 28.6%, P=0.870).
Conclusions: There were significant correlation between tumor size, lymphovascular invasion, pathological lymph node stage and survival rate, but not between the Siewert classification and survival rate. No independent risk factor was found which can indicate the postoperative survival rate of AEG.