Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma: A Retrospective Multicenter Study: Reply

World Journal of Surgery, Jan 2017

Tatsuo Matsuda, Hiroya Takeuchi

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://link.springer.com/content/pdf/10.1007%2Fs00268-017-3880-3.pdf

Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma: A Retrospective Multicenter Study: Reply

World J Surg Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma: A Retrospective Multicenter Study: Reply Tatsuo Matsuda 0 Hiroya Takeuchi 0 0 Department of Surgery, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 , Japan - Dear editor We appreciate the valuable comments of Dr. Dimitrios Schizas and colleagues as well as their interest in our manuscript published in July 2016. In their letter, Schizas et al. queried whether T4b esophagogastric cancer invaded the aorta. In our study, 122 patients (30.5%) were diagnosed with T4 esophagogastric cancer, 17 of which were offered a R1 resection [ 1 ]. Unfortunately, in this retrospective multicenter study, we did not collect data concerning adjacent tissues that were invaded. Therefore, we are unable to provide a definitive answer; however, it is the general policy of our hospital to not offer surgery as treatment for T4b with aorta invasion. As we reported, the 5-year overall survival (OS) rate for patients who underwent a R1 resection was 25.9% (that of patients who underwent a R0 resection was 60.8%). Furthermore, R1 resection was reported to be an independent risk factor for poor OS in patients with pT4 esophageal cancer [ 2 ]. Therefore, we are also interested in stentgrafting in patients with T4b esophagogastric cancer that penetrates into the aorta after chemo- or chemoradiotherapy. This novel treatment modality should benefit at least some patients and be less invasive compared to radical esophagectomy combined with descending aorta replacement [ 3 ]. However, as Schizas et al. mentioned, the indication of intra-aortic stent-grafting should be carefully discussed because of its high cost and relative invasiveness. For example, patients with multiple lymph node metastases 1. Matsuda T , Kurokawa Y , Yoshikawa T , Kishi K , Misawa K , Ohi M et al ( 2016 ) Clinicopathological characteristics and prognostic factors of patients with siewert type II esophagogastric junction carcinoma: a retrospective multicenter study . World J Surg . 40 ( 7 ): 1672 - 1679 2. Shimada H , Shiratori T , Okazumi S , Matsubara H , Nabeya Y , Shuto K et al ( 2008 ) Have surgical outcomes of pathologic T4 esophageal squamous cell carcinoma really improved? Analysis of 268 cases during 45 years of experience . J Am College Surg 206 : 48 - 56 3. Cong Z , Diao Q , Yi J , Xiong L , Wu H , Qin T et al ( 2014 ) Esophagectomy combined with aortic segment replacement for esophageal cancer invading the aorta . Ann Thorac Surg 97 : 460 - 466 (...truncated)


This is a preview of a remote PDF: https://link.springer.com/content/pdf/10.1007%2Fs00268-017-3880-3.pdf

Tatsuo Matsuda, Hiroya Takeuchi. Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma: A Retrospective Multicenter Study: Reply, World Journal of Surgery, 2017, pp. 1395-1395, Volume 41, Issue 5, DOI: 10.1007/s00268-017-3880-3