[Effect of splenic hilar lymphadenectomy on locally advanced Siewert type â
¡ and â
¢ adenocarcinoma of esophagogastric junction with a tumor diameter ≥4 cm: a five-year survival analysis].
Zhonghua Wai Ke Za Zhi
; 60(9): 853-859, 2022 Sep 01.
Article
in Zh
| MEDLINE
| ID: mdl-36058712
ABSTRACT
Objective:
To examine the long term outcome of splenic hilar lymphadenectomy (SHL) for locally advanced Siewert type â ¡ and â ¢ adenocarcinoma of esophagogastric junction (AEG) with a tumor diameter ≥4 cm.Methods:
A total of 489 locally advanced Siewert type â ¡ and â ¢ AEG patients with a tumor diameter ≥4 cm who underwent radical resection from January 2010 to April 2016 were included. There were 383 males and 106 females. There were 225 patients aged≥65 years and 264 patients aged <65 years. SHL was conducted in 270 patients(SHL group). Wilcoxon rank-sum test or χ2 test were conducted for inter-group comparison. Cox proportional hazard regression was used to analyze the long term outcome of SHL and the prognosis factors of overall survival. Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test.Results:
Followed-up to April 2021,the median follow-up time was 78.0 months (range 74.0 to 85.0 months), the follow-up rate was 95.5%(467/489). The splenic hilar lymphnode metastasis rate of the SHL group was 12.6% (34/270). Younger patients (<65 years old), less complications, higher proportion of patients received adjuvant chemotherapy were demonstrated in the SHL group (χ2 5.644 to 6.744, all P<0.05). Multivariate analysis showed that SHL was the independent prognosis factor of overall survival for patients with Siewert type â ¡ and â ¢ AEG and a tumor diameter≥4 cm (HR=0.68, 95%CI 0.52 to 0.88, P=0.004) along with preoperative CA19-9, pathological T stage, pathological N stage, adjuvant chemotherapy and postoperative complication. Further subgroup analysis demonstrated that the SHL group had better 5-year overall survival than non-SHL group (62.4% vs. 39.2%, χ2=17.983, P=0.006) in Siewert type â ¢ AEG rather than in Siewert type â ¡ AEG(57.3% vs. 53.7%, χ2=3.031, P=0.805).Conclusion:
In experienced center, splenic hilar lymphadenectomy can improve the prognosis of Siewert type â ¢ AEG with a tumor diameter ≥4 cm.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Stomach Neoplasms
/
Adenocarcinoma
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
Zh
Journal:
Zhonghua Wai Ke Za Zhi
Year:
2022
Type:
Article
Affiliation country:
China