Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era

Introduction: Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG. Methods: Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained. Results: We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028). Conclusion: AEGJ is associated with high rates of early recurrence. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

In a study of 188 patients undergoing surgical resection for AEGJ, recurrence was observed in 38.3% of patients, with locoregional recurrence accounting for 23.6%, peritoneal recurrence for 27.8%, and distant metastasis for 48.6%. Tumors larger than 5 cm were identified as a risk factor for peritoneal recurrence, while lymph node metastasis was associated with distant recurrence.