Risk factors of lymph node metastasis and prognosis in early stage Ⅱ and Ⅲ gastroesophageal junctional adenocarcinoma / 中华普通外科杂志

ABSTRACT

Objective To investigate the risk factors affecting early stage Ⅱ and Ⅲ gastroesophageal junctional adenocarcinoma lymph node metastasis,and to explore the impact of lymph node metastasis on prognosis.Methods From Jan 2007 to Jan 2014,220 early stage Ⅱ/Ⅲ gastroesophageal junction adenocarcinoma cases underwent radical resection and were followed-up.Kaplan-Meier analysis was made on lymph node metastasis in relation with patient prognosis.Results Lymph node metastasis rate was 13.1％ in the early stage Ⅱ and Ⅲl gastroesophageal junction adenocarcinoma,tumor diameter ≥2 cm,undifferentiated type and infiltrating submucosa were independent risk factors for early stage Ⅱ/Ⅲ AEG lymph node metastasis.The l-year overall survival rates of patients with early stage Ⅱ / Ⅲ AGE lymph node metastasis and without lymph node metastasis were 93.1％ (27/29) and 98.4％ (188/191),P =0.130.The 3-year overall survival rates of the lymph node metastasis group and without lymph node metastasis group were65.5％ (19/29) and 91.6％ (175/191),respectively.(P=0.000).Conclusion Patients with early stage Ⅱ and Ⅲ gastroesophageal junctional adenocarcinoma with tumor diameter ≥ 2 cm,undifferentiated and infiltrating submucosa have a higher risk of lymph node metastasis,which is related to poor prognosis.