Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

Gobbi,Paolo  G.; Bergonzi,Manuela; Pozzoli,Donatella; Villano,Lara; Vanoli,Alessandro; Corbella,Franco; Dionigi,Paolo; Corazza,Gino  R.

doi:10.3892/ol.2011.278

May-June 2011 Volume 2 Issue 3

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May-June 2011 Volume 2 Issue 3

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Article

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

Authors:
- Paolo G. Gobbi
- Manuela Bergonzi
- Donatella Pozzoli
- Lara Villano
- Alessandro Vanoli
- Franco Corbella
- Paolo Dionigi
- Gino R. Corazza
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Affiliations: Medicina Interna e Gastroenterologia, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy, Dipartimento di Patologia Umana ed Ereditaria, Sezione di Anatomia Patologica, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia 27100, Italy, Dipartimento di Onco-Ematologia, Sezione di Radioterapia Oncologica, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia 27100, Italy, Dipartimento di Scienze Chirurgiche, Sezione di Chirurgia Generale, Università di Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia 27100, Italy
Pages: 503-507
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Published online on: March 21, 2011

https://doi.org/10.3892/ol.2011.278
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Abstract

The issue of whether carcinoma of the gastroesophageal junction (GEJ) should be considered a distal esophageal, a proximal gastric or an independent tumor, at least with regards to clinical evaluation and management remains controversial. This study included 613 retrospective consecutive patients with carcinoma of the upper digestive tract, 64 of the esophagus, 58 of the GEJ and 491 of the stomach. The prognostic impact of the main clinical and histological parameters was analyzed in relation to relative survival as an estimate of the excess mortality. Relative survival and standardized mortality ratio (SMR) were calculated from the observed survival and the expected survival of the general population with identical age, gender and calendar years of observation. Multivariate analyses were applied to the proportional hazards model of the relative survival. The excess mortality, expressed by the relative survival and SMR of the patients with GEJ carcinoma are intermediate compared to those of patients with esophageal and gastric tumors. However, prognosis is not determined by tumor location, histology or administration of adjuvant chemotherapy, but mainly by stage and radical surgical resection. Gender has a minor but significant prognostic effect and age showed a slight inverse correlation with excess mortality. In conclusion, the excess mortality related to the tumors of the upper digestive tract is determined by stage, radical resection, gender and age. The intermediate prognosis of GEJ tumors mainly depends on a particular combination of such elementary determinants.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Tumors of the gastroesophageal junction have intermediate prognosis compared to tumors of the esophagus and stomach, but share the same clinical determinants

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