Long-Term Outcomes and Risk Factors for Lymph Node Metastasis in Siewert Type II/III Early Gastric Cancer.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Oncology

Background:

• Adenocarcinomas of the esophagogastric junction (EGJ) and cardia are increasing in the East.
• Cancers of the EGJ and gastric cardia have poor prognoses.

Purpose of the Study:

• Investigate lymph node metastasis (LNM) rates in Siewert type II/III early gastric cancer (EGC).
• Identify predictive factors for LNM in EGC.
• Determine long-term outcomes for patients with Siewert type II/III EGC.

Main Methods:

• Retrospective analysis of 130 patients with Siewert type II/III EGC who underwent total gastrectomies.
• Logistic regression model to analyze factors associated with LNM.
• Kaplan-Meier analysis for survival rates.

Main Results:

• 7.7% of patients with Siewert type II/III EGC had LNM.
• Macroscopically elevated lesions and lymphovascular invasion were significantly associated with LNM (p<0.001).
• Five-year overall and disease-specific survival rates were 90.0% and 98.9%, respectively.

Conclusions:

• Siewert type II/III EGC patients treated with total gastrectomy demonstrate favorable long-term outcomes.
• Macroscopically elevated lesions and lymphovascular invasion are key predictors of LNM in this patient group.