Ten-year review of patients with resected esophagogastric junction adenocarcinoma in the Philippine General Hospital.
https://doi.org/10.47895/amp.vi0.2452
- Author:
Shiela S. Macalindong
1
;
Arturo S. Dela Pena
1
;
Brian Buckley
2
Author Information
1. Division of Surgical Oncology, Head and Neck, Breast, Skin and Soft Tissue, and Esophagogastric Surgery, Department of Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila
2. Department of Surgery, Philippine General Hospital, University of the Philippines Manila
- Publication Type:Journal Article
- Keywords:
esophagogastric junction;
gastroesophageal junction;
adenocarcinoma
- From:
Acta Medica Philippina
2021;55(4):387-397
- CountryPhilippines
- Language:English
-
Abstract:
OBJECTIVE:To describe the clinicopathologic profile, management, and outcomes of patients with esophagogastric
junction (EGJ) adenocarcinoma in the local setting.
METHODS:Data was obtained from patients who had curative surgery for EGJ adenocarcinoma from 2004–2013 in
the Philippine General Hospital. We used student's T-tests, analysis of variance, chi-squared and Fisher’s exact tests
for comparisons and Cohen’s kappa index for correlation. A P value of less than or equal to 0.05 was considered
significant.
RESULTS:We included 88 patients (81.2% male) with mean age of 55.2 years. Eight percent were clinical Siewert
type I; 23.9% were type II; 15.9% were type III; and majority (52.3%) were unknown type. Surgical approach and
resection differed across the Siewert types (P<0.000). Thoracoabdominal approach (72.7%) and distal esophagectomy
with total gastrectomy (77.3%) were the most common procedures. Many had at least pathologic T3 (80.6%), N2
(54.5%), and stage III (68.2%) disease. Neoadjuvant and adjuvant chemotherapy was given in 1.2% (1/82) and 48.6%
(18/37), respectively. In-hospital morbidity was 40%; mortality was 4.5%; 1-year disease-free survival rate was 69.4%;
and overall survival rate was 76.5%. Correlation was fair between preoperative and pathologic Siewert type (P=0.003)
and poor between clinical and pathologic stage (P=0.115). Patients with recurrence had higher pathologic lymph
nodes (P=0.029) and more advanced stage (P=0.022).
CONCLUSION:EGJ adenocarcinomas were locally advanced and had poor outcomes. Surgery should be individualized
and multimodality approach considered.
- Full text:Ten-year review of patients with resected esophagogastric junction adenocarcinoma in the Philippine General Hospital.pdf
