PS01.151: STRATEGY FOR TREATMENT OF ADENOCARCINOMA IN THE ESOPHAGO-GASTRIC JUNCTION (SIEWERT TYPE II)

Abstract Background Incidence of adenocarcinoma of the esophagogastric junction is increasing in Japan as Europe or America. However, there is no consensus on treatment strategy. The purpose of this study was to determine the optimal range of resection and lymph node dissection according to lymph node metastasis status in adenocarcinoma of the esophagogastric junction Methods We investigated 75 patients who were diagnosed with advanced adenocarcinoma(A) of the esophagogastric junction and 22 patients were diagnosed with early adenocarcinoma(B). Results (1) Location(EG: E = G: GE: G) A = 37:20:17:1 B = 5:4:13(2)The depth of tumor (m2: m3: sm1: sm2: sm3: T2: T3: T4) = 1:6:2:10:3:13:59:3)(3) Degree of lymph node metastasis(n + : n-) A = 49:26 B = 4:18 (4) Surgical approach (Right thoracotomy:Left thoracoabdominal incision:Laparotomy (Transhiatal approach) A = 13:47:15 B = 1:5:16 (5) Neoadjuvant therapy (Chemotherapy before operation:Chemo-radiotherapy before operation:Chemotherapy after operation:Chemo-radiotherapy after operation) A = 1:12:33:1 B were without neoadjuvant therapy (6) Lymph node metastasis (Number of metastasis of lymphnode/Area of the dissection of lymphnode) Cervical: Upper thoracic: Middle: Lower: abdominal A = (1/7, 2/13, 4/31, 15/62, 46/75) B = (0/1, 0/3, 0/8, 4/22) (7) Type of the recurrence (Cervical Lymph node: mediastainal lymphnode: abdominal lymphnode: dissemination: Liver: Lung: Born: Remunant esophagus: Skin: Brain: Other disease) A = (3:8:6:13:9:4:2:1:1:1) B = (0:0:0:0:1:0:1:0:0:0:3) (8) Index (metastatic rate x3-yearOS/100)A = No1: No2: No3: No.7: No11: No20: No110: No112 = 12.1:10.6:12.9:13.5:18.1:50:12.9:9.09 B were not showed because incidence of metastasis of the lymph node were low.(9) 5-years survival rate for advanced cancer was 38% and early cancer was 88% Conclusion Proximal gastrectomy may be a minimally invasive surgical technique in for early and advanced adenocarcinoma of the esophagogastric junction according to the lymph node metastasis status. Surgical resection has been mainstream treatment but It was necessary to perform definitive or neoadjuvant chemoradiotherapy. Disclosure All authors have declared no conflicts of interest.