Clinicopathological Study of Carcinoma of Esophagogastric Junction -Comparison of Squamous Cell Carcinoma and Adenocarcinoma-

Shin-ichi Murakami, Tsuyoshi Noguchi, Tsuyoshi Hashimoto, Shin-suke Takeno, Yoshinori Hiraoka, Yuzo Uchida

Department of Surgery II, Oita Medical University

Clinicopathological studies of carcinoma of the esophagogastric junction were performed in comparison with 15 cases of squemous cell carcinoma and 36 cases of adenocarcinoma. Tumors of 7 patients with squamous cell carcinoma (46.7%) were located in the esophagus mainly located involving the esophagogastric junction (EC), and those of 25 patiens with adenocarcinoma (69.4%) were distributed in the stomach mainly located involving the esophagogastric junction (CE). The incidence of adenocarcinomas located in the CE was significantly higher than for that of squemous cell carcinomas (p<0.01). Patients with squamous cell carcinoma had significantly longer esophageal distance of carcinoma than those with adenocarcinoma (p<0.01). In so patients receiving left thoracotomy the distance from the proximal edge of the carcinoma to the resected esophageal edge was significantly longer than that in those operated on by the trans-abominal approach (p<0.001). The majority of patients with tumors with characteristics intermediate between squamous cell carcinoma and adenocarcinoma had metastasis of the lower mediastinal and abdominal lymph nodes. The 5-year survival rates for patients with squamous cell carcinoma and adenocarcinoma were 32.3% and 16.1%, respectively, and both had a poor prognosis. Therefore, it is important for patients with carcinoma of the esophagogastric junction involving the esophageal hiatus that lower esophagectomy and total gastrectetomy with left thoracotomy and laparatomy are preformed regardless of the histological type, along with intensive and reasonable lymph node dissection of lower mediastinal and abdominal lymph nodes.

Key words
carcinoma of esophagogastric junction, squamous cell carcinoma, adenocarcinoma

Reprint requests
Shin-ichi Murakami Department of Surgery II, Oita Medical University
Hasama-machi, Oita 879-5593, JAPAN

Accepted
February 12, 1998

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