Risk factors and prognosis in patients with adenocarcinoma of esophagogastric junction with lymph node metastasis of Siewert II/III.

Adenocarcinoma of the esophagogastric junction (AEG) has a high incidence, while the extent of lymph node dissection and prognosis are still controversial. This study aimed to explore the risk factors of lymph node metastasis and prognosis in Siewert II/III AEG patients. Between July 2013 and May 2017, a total of 65 patients who underwent surgical operation in Beijing Friendship Hospital were retrospectively reviewed. The patients were followed up until September 2017. Data were analyzed using logistic regression. Survival analyses were performed using Kaplan-Meier. Multivariate analysis revealed that histologic classification (OR=3.437, 95% CI: 1.046~11.294, P=0.042) and intravascular cancer embolus (OR=6.614, 95% CI: 1.942~22.524, P=0.003) were correlated with lymph node metastasis. The lymph nodes No. 1, 2, 3, 7, 11 and 110 indicated higher metastatic rate. The 3-year overall survival analysis revealed that lymph node metastasis (P=0.167) and tumor stage (P=0.429) exhibited no significant differences. Findings suggest that histologic type and vascular neoplasia are independent risk factors for lymph node metastasis. For Siewert II/III AEG patients, it is reasonable to perform radical gastrectomy combined with D2 lymph node dissection. For No. 110 lymph nodes should be dissected routinely. However, the long-term prognosis remains to be further studied.