CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(09): E868-E874
DOI: 10.1055/s-0043-115388
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Tumor location is a risk factor for lymph node metastasis in superficial Barrett’s adenocarcinoma

Masayoshi Yamada1, Ichiro Oda1, Hirohito Tanaka1, Seiichiro Abe1, Satoru Nonaka1, Haruhisa Suzuki1, Shigetaka Yoshinaga1, Aya Kuchiba2, Kazuo Koyanagi3, Hiroyasu Igaki3, Hirokazu Taniguchi4, Shigeki Sekine5, Yutaka Saito1, Yuji Tachimori3
  • 1Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • 2Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo Japan
  • 3Esophageal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
  • 4Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
  • 5Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan
Further Information

Publication History

submitted 20 October 2016

accepted after revision 26 June 2017

Publication Date:
12 September 2017 (online)

Abstract

Background and study aims Endoscopic treatment is indicated for superficial Barrett’s adenocarcinoma (BA) with a negligible risk of lymph node metastasis (LNM). However, risk factors associated with LNM in superficial BA are still not well characterized. The aim of the current study was to clarify risk factors for LNM of superficial BA.

Patients and methods A retrospective study was conducted in 87 consecutive patients with BA that was resected at National Cancer Center Hospital, Tokyo, Japan between 1990 and 2013. We assessed tumor size, macroscopic type, histological type, tumor depth of invasion, lymphovascular invasion and tumor location to analyze factors associated with LNM. Tumor location was classified into following 2 groups according to Siewert classification: 1) BA of the esophagogastric junction (EGJ-BA) as those having their center within 1 cm proximal from the EGJ; and 2) Esophageal-BA as those having their center at 1 cm or more proximal to the EGJ. EGJ was defined as distal end of the palisade vessels.

Results LNM was detected in 10 (11 %) patients. Univariable analysis revealed that tumor size, tumor depth of invasion, histological type of mixed differentiated and undifferentiated-type adenocarcinoma, lymphovascular invasion and tumor location of esophageal-BA were significantly associated with LNM. Multivariable analysis revealed that tumor location of esophageal-BA [odds ratio 7.8 (95 %CI: 1.3 – 48.1)] was a potential risk factor for LNM.

Conclusions The current study demonstrated that tumor location is a potential risk factor for LNM in BA. Therefore, indications for endoscopic treatment of esophageal-BA and EGJ-BA could be different.