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| ORIGINAL ARTICLE |
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| Year : 2015 | Volume
: 11
| Issue : 5 | Page : 122-124 |
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The postoperative complication for adenocarcinoma of esophagogastric junction
Hui Zhang1, Xianglin Meng2
1 Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui 230032; Department of Surgery Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
2 Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui 230032, China
| Date of Web Publication | 31-Aug-2015 |
Correspondence Address:
Dr. Xianglin Meng
Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui 230032
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-1482.163867
Objective: The purpose of this study was to evaluate the postoperative complications for patients with adenocarcinoma of esophagogastric junction.
Methods: Two hundred and eighty subjects with adenocarcinoma of esophagogastric junction who received operation were retrospectively analyzed from June 2006 to December 2010 in the Department of Oncology of First Affiliated Hospital of Bengbu Medical College, Bengbu, China. The postoperative complication such as ventricular premature beat, atrial fibrillation, supraventricular tachycardia, heart failure, pulmonary infection, pulmonary atelectasis, respiratory failure, bronchospasm, anastomotic leakage, gastroplegia, pleural infection, and cerebral accident were reviewed and recorded by to doctors. Moreover, the correlation between clinical characteristics and postoperative complication was analyzed by statistical methods.
Results: A total of 70 complications were found for the included 280 cases of adenocarcinoma of esophagogastric junction with general incidence of 25%. For the relationship between clinical characteristics and postoperative complication analysis, no significant association of gender, age, operation time, operative approach, tumor differentiation, and clinical states was found with the postoperative complications (P > 0.05); but the complication rate in patients with basic disease of heart and lung was significant than the patients without this kind of disease (P < 0.05).
Conclusion: The positive operative complications for patients with adenocarcinoma of esophagogastric junction were relative high. Moreover, basic heart and lung diseases can increase the risk of developing positive operative complications. Keywords: Adenocarcinoma of esophagogastric junction, complication, operation, risk factors
How to cite this article:
Zhang H, Meng X. The postoperative complication for adenocarcinoma of esophagogastric junction. J Can Res Ther 2015;11, Suppl S1:122-4 |
| > Introduction | |  |
Adenocarcinoma of esophagogastric junction is a cancer of the lower part of the esophagus, often linked to a Barrett's esophagus. [1] The epidemiology study indicated that the incidence of esophagogastric junctional adenocarcinoma is rising rapidly in Western countries, in contrast to the declining of distal gastric adenocarcinoma. [2] The treatment strategy for this kind of disease is limited, and the overall prognosis is relatively poor. [3] The etiology, classification, surgery, and general treatment for this disease was not coincident with each other for the published articles related to adenocarcinoma of esophagogastric junction. [4] In general, for its poor relative prognosis, a multidisciplinary approach is necessary, with surgical resection, chemotherapy, and radiation depending on the clinical characteristics of individual patients. [5],[6],[7] In this present study, we retrospectively analyzed 280 case of adenocarcinoma of esophagogastric junction who received surgery treatment, and discussed the risk factors for postoperative complications for this disease.
| > Methods | | |
Patients included in this study
Two hundred and eighty subjects with adenocarcinoma of esophagogastric junction who received operation were retrospectively analyzed from June 2006 to December 2010 in the Department of Oncology of First Affiliated Hospital of Bengbu Medical College, Bengbu, China. For the included 280 cases, the mean age was 64.6 years old with 208 case of male patients and 72 subjects of female patients. The detailed information for the tumor differentiation and clinical stage was demonstrated in [Table 1].
Clinical characteristics and complications records
The clinical characteristics such as age, gender tumor differentiation, and complication were extracted by two authors independently in our hospital patient database. Any disagreements between the two authors were resolved by discussion.
Statistical analysis
Data were analyzed using SPSS 17.0 software (http://www-01.ibm.com/software/analytics/spss/). Results were expressed as the mean ± standard deviation. The significance of differences between means was assessed using the Student's t-test. Differences were considered significant at P < 0.05.
| > Results | | |
The general incidence of postoperative complication
A total of 70 complications were found for the included 280 cases of adenocarcinoma of esophagogastric junction with general incidence of 25% [Table 2].
Risk factors for positive operative complication
For relationship between clinical characteristics and postoperative complication analysis, no significant association of gender, age, operation time, operative approach, tumor differentiation, and clinical states was found with the postoperative complications (P > 0.05); but the complication rate in patients with basic disease of heart and lung was significant than the patients without this kind of disease (P < 0.05) [Table 3]. | Table 3: The relationship between clinical characteristics and postoperative complication
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| > Discussion | | |
Tumor epidemiology study indicated that gastric tumors are one of the most common carcinoma with approximately 930,000 new cases and 700,000 related deaths worldwide each year. [8] For the past 20 years, the incidence of proximal gastric carcinoma was generally decreased. However, the incidence of adenocarcinoma of esophagogastric junction is increased which take part in 50% of all the diagnosed gastric malignant tumors. [7] According to Siewert's classification, the adenocarcinoma of esophagogastric junction is divided into three types: Type I : t0 umor center located 1-5 cm above the gastric cardia; type II : t0 umor center between 1 cm above and 2 cm below the gastric cardia; and type III : t0 umor center located 2-5 cm below the gastric cardia. [9] This classification is useful for surgical management of adenocarcinoma of esophagogastric junction. However, it also has its own drawbacks. The classification system is based on anatomy findings which is not easy to use when the adenocarcinoma of esophagogastric junction is associated with hiatal hernia or when the tumor is voluminous. [7]
In general, more than half of the adenocarcinoma of esophagogastric junction patients have advanced disease when diagnosed with poor prognosis. [10] The combined treatment modality is required for management of this disease. However, the surgery remains important for resectable adenocarcinoma of esophagogastric junction. According to the literature, the type I and type III carcinomas was suitable for operation, but the type II tumors for surgery treatment remains inconclusive.
In this present study, we retrospectively analysis 280 cases with adenocarcinoma of esophagogastric junction who received the surgery treatment. We find the general postoperative complication was relative high with a total incidence of 25%. The most common positive complications are heart-related complication with an incidence rate of 15%. Moreover, in this study, we also find that the postoperative complication rate in patients with basic disease of heart and lung was significant higher than the patients without this kind of disease (P < 0.05). Hence, doctors should pay much attention to the patients with basic disease of heart and lung when performing the surgery treatment.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| > References | | |
| 1. | Deng JY, Liang H. Adenocarcinoma of esophagogastric junction. Chin J Cancer Res 2014;26:362-3.  |
| 2. | Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction : i0 ncidence, characteristics, and treatment strategies. Gastric Cancer 2010;13:63-73. |
| 3. | Jiang N, Guo S, Yuan H, Zhou Z, Wang Y, Lei J. Adenocarcinoma of the esophagogastric junction : h0 ow to measure the tumor volume? Radiology 2013;269:621-2. |
| 4. | Huang L, Xu AM. Adenocarcinoma of esophagogastric junction : c0 ontroversial classification, surgical management, and clinicopathology. Chin J Cancer Res 2014;26:226-30. |
| 5. | Hosoda K, Yamashita K, Katada N, Moriya H, Mieno H, Sakuramoto S, et al. Benefit of neoadjuvant chemotherapy for Siewert type II esophagogastric junction adenocarcinoma. Anticancer Res 2015;35:419-25. |
| 6. | Zhang XD, Shu YQ, Liang J, Zhang FC, Ma XZ, Huang JJ, et al. Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: A multicenter prospective study. Chin J Cancer Res 2012;24:291-8. |
| 7. | Gronnier C, Piessen G, Mariette C. Diagnosis and treatment of non-metastatic esophagogastric junction adenocarcinoma : w0 hat are the current options? J Visc Surg 2012;149:e23-33. |
| 8. | Corley DA, Buffler PA. Oesophageal and gastric cardia adenocarcinomas : a0 nalysis of regional variation using the Cancer Incidence in Five Continents database. Int J Epidemiol 2001;30:1415-25. |
| 9. | Stein HJ, Feith M, Mueller J, Werner M, Siewert JR. Limited resection for early adenocarcinoma in Barrett′s esophagus. Ann Surg 2000;232:733-42. |
| 10. | Yamada M, Oda I, Nonaka S, Suzuki H, Yoshinaga S, Taniguchi H, et al. Long-term outcome of endoscopic resection of superficial adenocarcinoma of the esophagogastric junction. Endoscopy 2013;45:992-6. |
[Table 1], [Table 2], [Table 3]
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