BACKGROUND The number of patients with esophagogastric junction (EGJ) cancers has tended to increase. However, no clear consensus on the optimum treatment policy has yet been reached. METHODS This study included patients diagnosed with adenocarcinoma of Sievert type II in whom resection was performed in our hospital. We performed a clinicopathological examination, and patients were divided into two groups by the tumor size: L group, tumor size ≥4 cm; and S group, tumor size < 4 cm. The clinical factors, such as nodal dissection and recurrence pattern, were then analyzed. RESULTS A total of 48 patients were diagnosed with ECJ cancers. The average tumor size was 55.1 mm, and 32 cases (66.7%) had tumors ≥4 cm. Metastasis to the mediastinum was noted in 4 cases (12.5%) in the L group but none in the S group. Recurrence in the upper or middle mediastinum lymph nodes was noted in 3 cases (9.4%) in the L group. The 5-year overall survival rates were 49.7 and 83.9% in the L and S groups, respectively. CONCLUSIONS As the tumor grows large, it is difficult to accurately judge EGJ on the image, and as a result it is difficult to understand the exact esophageal invasion distance of the tumor. Therefore, lymph node dissection including the upper mediastinum is considered vital, regardless of the degree of esophageal invasion.

中文翻译：

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基于肿瘤直径的食管胃交界性肿瘤的手术治疗策略。

背景技术患有食管胃接合部（EGJ）癌症的患者数量趋于增加。但是，尚未就最佳治疗政策达成明确共识。方法本研究纳入诊断为Sievert II型腺癌的患者，这些患者在我院进行了切除术。我们进行了临床病理检查，根据肿瘤大小将患者分为两组：L组，肿瘤大小≥4cm； L组，肿瘤大小≥4cm。和S组，肿瘤大小＜4厘米。然后分析临床因素，例如淋巴结清扫和复发模式。结果共有48例患者被诊断出患有ECJ癌症。平均肿瘤大小为55.1毫米，肿瘤≥4厘米的病例为32例（66.7％）。L组有4例（12.5％）转移至纵隔，而S组无转移。L组3例（9.4％）出现上纵隔或中纵隔淋巴结复发。L组和S组的5年总生存率分别为49.7％和83.9％。结论随着肿瘤的增大，很难在图像上准确判断EGJ，因此难以理解肿瘤在食道上的确切侵袭距离。因此，无论食管侵犯的程度如何，包括上纵隔在内的淋巴结清扫都被认为是至关重要的。结果，很难理解肿瘤在食道上的确切侵入距离。因此，无论食管浸润的程度如何，包括上纵隔在内的淋巴结清扫都被认为是至关重要的。结果，很难理解肿瘤在食道上的确切侵入距离。因此，无论食管浸润的程度如何，包括上纵隔在内的淋巴结清扫都被认为是至关重要的。