The Preoperative Lymphocyte to Monocyte Ratio Predicts Clinical Outcome In Resected Patients With T2-4N0-3M0 Siewert Type II/III Adenocarcinoma Of The Esophagogastric Junction

Abstract Background Inflammation has a critical role in the pathogenesis and progression of cancer. The lymphocyte to monocyte ratio (LMR) could be a new biomarker in various tumors. Aims We analyzed the LMR with clinicopathological parameters and outcome in resected patients with T2-4N0-3M0 Siewert type II/III of advanced adenocarcinoma of the esophagogastric junction (AEG) . Methods A total of five hundred and seventy-one patients with Siewert type II/III of AEG between Jan 2006 and Jun 2012 were included in this retrospective study. Kaplan-Meier curves were used to calculate the cancer-specific survival (CSS). Univariate and multivariate Cox-regression analyses were performed to evaluate the prognostic factors. Results We set 3.64 as the cut-off level based on the receiver operating characteristic curve. The preoperative absolute lymphocyte count tended to decrease in ‘LMR≤3.64’ group, and the preoperative absolute monocyte count tended to decrease in ‘LMR＞3.64’ group. The decreased preoperative LMR was significantly associated with decreased CSS in univariate (HR:2.311, 95%CI:1.639-3.254, P=0.008) and multivariate analysis (HR:1.642, 95%CI:1.242-2.171, P=0.027 ). According to the treatment regimen(surgery alone versus surgery and adjuvant chemotherapy), no significant difference in the 5-year CSS was identified in ‘high-risk’ group (LMR≤3.64) (HR: 1.121, 95%CI: 0.733-1.725, P=0.605). Conclusions The LMR might be an independent prognostic marker for CSS in resected patients with T2-4N0-3M0 Siewert type II/III of advanced AEG. When the ‘high-risk’ patients with LMR≤3.64 were analyzed, no benefit of adjuvant 5-FU-based chemotherapy could be found.

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Proximal Gastrectomy versus Total Gastrectomy for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Comprehensive Analysis of Data from the SEER Registry

Disease Markers ◽

10.1155/2019/9637972 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Kaixuan Zhu ◽

Yingying Xu ◽

Jiaxin Fu ◽

Farah Abdidahir Mohamud ◽

Zongkui Duan ◽

...

Keyword(s):

Total Gastrectomy ◽

Surgical Approach ◽

Esophagogastric Junction ◽

Proximal Gastrectomy ◽

Locally Advanced ◽

Cox Proportional Hazards Model ◽

Type Ii ◽

Siewert Type ◽

Siewert Type Ii ◽

Significant Difference

Background. To determine the ideal surgical approach (total gastrectomy (TG) vs. proximal gastrectomy (PG)) for Siewert type II adenocarcinoma of the esophagogastric junction (AEG), we searched and analyzed the Surveillance, Epidemiology, and End Results (SEER) data. Methods. Patients with Siewert type II AEG treated by TG or PG were identified from the 2004–2014 SEER dataset. We obtained the patients’ overall survival (OS) and cancer-specific survival (CSS) and stratified the patients by surgical approach. We performed a propensity score 1 : 1 matching (PSM) analysis and a univariate and multivariate Cox proportional hazards model. Results. A total of 2,217 patients with 6th AJCC stage IA–IIIB Siewert type II AEG was examined: 1,584 patients (71.4%) underwent PG, and 633 patients (28.6%) underwent TG. The follow-up time was 1–131 months. OS favored total gastrectomy before the PSM analysis (χ2=3.952, p=0.047), but after this analysis, there was no significant difference between TG and PG (χ2=2.227, p=0.136). The univariate and multivariate analyses identified age as an independent factor, and an X-tail analysis revealed 70 years as a cut-off point. The patients aged≥70 years obtained a significant long-term OS benefit from PG compared to TG (χ2=8.245, p=0.004), and those aged<70 years showed no difference between TG and PG (χ2=0.167, p=0.682). Conclusions. PG showed an equivalent survival benefit to TG in both the early and locally advanced stages of Siewert type II AEG. For elderly patients, PG is strongly recommended because of its clearer OS benefit compared to TG.

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The prognostic relevance of parapyloric lymph node metastasis in Siewert type II/III adenocarcinoma of the esophagogastric junction

Annals of Oncology ◽

10.1093/annonc/mdx261.123 ◽

2017 ◽

Vol 28 ◽

pp. iii48-iii49

Author(s):

Changming Huang ◽

Jia-Bin Wang ◽

Chao-Hui Zheng ◽

Ping Li ◽

Jian-Wei Xie

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Esophagogastric Junction ◽

Type Ii ◽

Siewert Type ◽

Siewert Type Ii ◽

Node Metastasis ◽

Prognostic Relevance

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A prospective appraisal of preoperative body mass index in D2-resected patients with non-metastatic gastric carcinoma and Siewert type II/III adenocarcinoma of esophagogastric junction: results from a large-scale cohort

Oncotarget ◽

10.18632/oncotarget.19251 ◽

2017 ◽

Vol 8 (40) ◽

pp. 68165-68179 ◽

Cited By ~ 4

Author(s):

Lei Huang ◽

Zhi-Jian Wei ◽

Tuan-Jie Li ◽

Yu-Ming Jiang ◽

A-Man Xu

Keyword(s):

Body Mass Index ◽

Gastric Carcinoma ◽

Body Mass ◽

Esophagogastric Junction ◽

Large Scale ◽

Type Ii ◽

Siewert Type ◽

Siewert Type Ii ◽

Preoperative Body Mass Index ◽

Adenocarcinoma Of Esophagogastric Junction

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Should Adenocarcinoma of the Esophagogastric Junction Be Classified as Esophageal Cancer? Limited to Siewert Type II, Yes

Annals of Surgery ◽

10.1097/sla.0000000000000589 ◽

2015 ◽

Vol 261 (3) ◽

pp. e67

Author(s):

Hiroharu Yamashita ◽

Hitoshi Katai

Keyword(s):

Esophageal Cancer ◽

Esophagogastric Junction ◽

Type Ii ◽

Siewert Type ◽

Siewert Type Ii

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Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

Journal of International Medical Research ◽

10.1177/0300060518802923 ◽

2018 ◽

Vol 47 (1) ◽

pp. 398-410 ◽

Cited By ~ 2

Author(s):

Can Hu ◽

Hao-te Zhu ◽

Zhi-yuan Xu ◽

Jian-fa Yu ◽

Yi-an Du ◽

...

Keyword(s):

Lymph Node ◽

Survival Rate ◽

Postoperative Complications ◽

Total Gastrectomy ◽

Surgical Approach ◽

Esophagogastric Junction ◽

Abdominal Cavity ◽

Type Ii ◽

Siewert Type ◽

Siewert Type Ii

Objective The optimal surgical approach for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is controversial. In this study, we evaluated the outcomes of total gastrectomy for Siewert type II/III AEG via the left thoracic surgical approach that is used at our center. Methods We identified 41 patients with advanced AEG in our retrospective database and analyzed their 3-year survival rate, upper surgical margin, postoperative complications, and index of estimated benefit from lymph node dissection. Results The 3-year overall survival rate of the whole group was 63%, but no difference was observed between Siewert type II and III AEGs. Esophageal exposure and lymphadenectomy were sufficient. Eight patients developed postoperative complications, but none of the patients developed anastomotic leakage. Dissection of lymph node station Nos. 19 and 110 may be necessary for patients with Siewert type II AEG. Multivariate analysis revealed that the cT category was the only independent risk factor. Conclusions Total gastrectomy via an approach from the abdominal cavity into the thoracic cavity may be an optimal surgical technique for advanced Siewert type II AEG.

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