[Primary esophageal adenocarcinoma]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Pathology

Background:

• Primary esophageal adenocarcinoma (PEAC) presents unique clinical characteristics.
• Understanding prognostic factors is crucial for optimizing treatment strategies.
• Comparison with esophageal squamous-cell carcinoma (ESCC) provides valuable context.

Purpose of the Study:

• To elucidate the clinical biocharacteristics of PEAC.
• To identify factors influencing patient prognosis.
• To establish appropriate surgical indications and combined therapeutic approaches.

Main Methods:

• Analysis of clinical data from 106 patients with PEAC who underwent surgery.
• Comparative analysis with patients diagnosed with ESCC.

Main Results:

• PEAC demonstrated similar resectability, morbidity, and mortality rates to ESCC.
• TNM staging, lymph node metastasis, extraesophageal invasion, and surgical approach significantly impacted prognosis.
• PEAC exhibited a lower 5-year survival rate (21.0%) compared to ESCC.
• Metastasis or recurrence was the leading cause of death in long-term survivors of PEAC.
• Adjuvant radiation improved survival in patients without lymph node metastasis.

Conclusions:

• PEAC is a more aggressive disease with a poorer prognosis than ESCC.
• Surgical resection is the principal treatment modality for PEAC.
• Surgical intervention is indicated across various stages of PEAC, including selected cases of stage IV.
• Early diagnosis, timely treatment, and curative surgery are vital for improving outcomes.
• Adjuvant radiation therapy shows benefit primarily in patients without lymph node metastasis.