Open AccessSURGICAL MANAGEMENT OF ADENOCARCINOMA OF ESOPHAGOGASTRIC JUNCTION - A TERTIARY CARE CENTRE EXPERIENCE IN SOUTH INDIA
Author(s) -
Karthikeyan Mohan,
Sivakumar kalyanashanmugam,
P.R. Venu Gopal,
Prabhakaran Raju,
Senthilkumar Rajendran,
Naganath Babu Obla Lakshmanamoorthy
Publication year - 2020
Publication title -
international journal of scientific research
Language(s) - English
DOI - 10.36106/ijsr/5600503
Subject(s) - medicine , esophagogastric junction , malignancy , adenocarcinoma , incidence (geometry) , surgery , stage (stratigraphy) , pathological , retrospective cohort study , general surgery , cancer , paleontology , physics , optics , biology
OBJECTIVE The incidence of adenocarcinoma of esophagogastric junction is on the rise. The optimal treatment strategy for these tumours has not been clearly established. The aim of this study is to analyse the clinical presentations, management and outcomes following surgery in patients with adenocarcinoma of the esophagogastric junction presenting to a tertiary care centre in South India.METHODS Retrospective analysis of prospectively maintained database was performed. Data of all patients operated for adenocarcinoma of esophagogastric junction was analysed with regards to surgical management and clinico-pathological outcomes.RESULTS Fifty two patients underwent surgery for esophagogastric junction malignancy in our institution from January 2015 to December 2018. Among them, type I, type II and type III tumours contributed to 6, 16 and 30 patients, respectively. Thirty-four patients (65.4%) were male. Mean age of the patients was 57 years. Six patients (11.5%) received neoadjuvant therapy. Fourteen patients (26.9%) were found to have unresectable or metastatic disease during surgery. Six patients (11.5%) underwent multiorgan resection. Mean tumour length was 5.4cm. Number of lymph nodes retrieved ranged from 2 to 25. Majority of the patients had stage 3 disease on histopathological examination. Major postoperative morbidity (Clavien Dindo grade ≥ 3) was seen in 9 patients. Reoperation was required in 4 patients. In-hospital mortality rate was 11.53%. On follow up, locoregional recurrence was documented in 5 patients.CONCLUSION Esophagogastric junction adenocarcinoma is an aggressive malignancy with high incidence of unresectable or metastatic disease. Majority of patients presented with larger tumours and at an advanced stage of the disease leading to poor outcomes.