Siewert Type II Esophageal Adenocarcinoma: Relationship Between Histology and Survival

Study Overview
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Brief Summary
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In Siewert type II adenocarcinoma, the relationship between adenocarcinoma sub types and survival, histologic/biologic patterns related to the presence/absence of gastric greater curvature metastases, were investigated.

Detailed Description
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In order to achieve further data on the biological patterns of intestinal and diffuse subtypes of esophageal adenocarcinoma (Lauren's classification), on the frequency of gastric greater curvature nodal stations and on the clinical relevance, in terms of prognosis and survival, of these parameters, a Siewert type II case series of Siewert type II adenocarcinomas, submitted to primary (no neoadjuvant therapy) surgical, studied, operated upon and followed up, were analysed. According to histologic patterns, cases were ordered in intestinal and diffuse adenocarcinoma sub types (Lauren's classification)and distinguished in Barret's, cardiopyloric, gastric types.

Official Title
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Siewert Type II Esophageal Adenocarcinoma: on the Relationship Between Histology, Esophageal-gastric Intestinal Metaplasia and Gastric Greater Curvature Lymphatic Metastases, Survival

Conditions
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Siewert Type II Adenocarcinoma of Esophagogastric Junction

Intervention / Treatment
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* Procedure: Total Gastrectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Siewert type II adenocarcinoma > 18 year submitted to primary surgery Exclusion Criteria: Siewert type II adenocarcinoma submitted to neoadjuvant therapy. Siewert type I adenocarcinoma. Siewert type III adenocarcinoma Squamous Carcinoma -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Total Gastrectomy|The esophagus was resected at the arch level of the azygos vein, a frozen section of the resection margin was routinely performed to achieve a proximal clean resection margin. The surgical specimen was comprehensive of distal esophagus, stomach and omentum. Digestive tract continuity was established with Roux-en-Y esophagojejunostomy. Lymphadenectomy was extended to the thoracic stations R 2-4, 7-8-9, and L 4, numbered according to the Mountain's classification [39] (Suppl. File 2 Figure A) and to the abdominal stations 1-12, numbered according to the Japanese Research Society for Gastric Cancer (JRSGC) 1998 classification.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival | 5 year survival between intestinal and diffuse types (Lauren's classification) of Siewert type II adenocarcinoma after primary surgery, | 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of gastric greater curvature lymph nodes metastases in Siewert II adenocarcinoma | Frequency of gastric greater curvature lymph nodes metastases and survival | 5 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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esophageal cancer, adenocarcinoma of the esophagus, esophageal surgery