Abstract
Background
To summarize the clinic and pathological characteristics of the primary esophageal adenocarcinoma and to discuss the reasonable diagnosis and treatment, further improve the curative effect.
Methods
The clinical data and therapeutic effect of 63 cases of esophageal adenocarcinoma treated from February 1995 to December 2011 in our department were analyzed retrospectively.
Results
There were 63 cases of primary esophageal adenocarcinoma, accounting for 0.66% (63/9608) of esophageal malignant tumors. There were 47 males and 16 females, with a ratio of 4. 4: 1, which was higher than that of esophageal squamous cell carcinoma (1.8: 1) in same period. There are no special characteristics in clinic syndrome and imaging. There were 12 cases of adenocarcinoma located in the middle thoracic segment of esophagus (19 cases) and 51 cases of lower thoracic segment of esophagus (81 cases), which were significantly different from predilection site of esophageal squamous cell carcinoma. TNM staging included 3 patients with stage I and 16 patients with stage II b. There were 23 patients with stage III and 4 patients with stage Ia. There were 32 cases of medullary type, 9 cases of mushroom type, 19 cases of ulcer type and 3 cases of constriction type. The pathological types were simple adenocarcinoma in 22 cases (34.9%), adenosquamous carcinoma in 27 cases (42.9%), adeno-Spina carcinoma in 14 cases (22.2%). All patients underwent partial esophagogastrostomy and esophagogastrostomy. 51 cases above aortic arch, 12cases below aortic arch. The resection rate was 100%, radical resection was 93.7% in 59 cases, palliative resection in 4 cases (6.3%), and positive stump in 2 cases (3.2%). The lymph node metastasis rate was 65.1% (41/63), higher than that of 31.6% esophageal squamous cell carcinoma in same period. There was no operative death in this group. The 1-year, 3-year, 5-year survival rates were 81.4%, 46.2% and 27.8% respectively, which was lower than synchronizational ESCC (89.7%, 68.2%, 38.6%).
Conclusion
Primary esophageal adenocarcinoma is a rare esophageal malignant tumor with high malignancy, strong invasion and high lymph node metastasis. It is important to pay attention to early diagnosis and treatment, mainly by surgical operation and adjuvant chemotherapy after operation to improve its long-term effect.
Disclosure
All authors have declared no conflicts of interest.
Erratum: Is there really no difference of mediastinal lymph node metastasis pattern between esophageal adenocarcinoma and squamous cell carcinoma?
