BACKGROUND AND AIMS Endoscopic resection (ER) of superficial adenocarcinoma of the esophagogastric junction (AEGJ) has been shown to be safe and effective. However, long-term data in patients undergoing ER for superficial AEGJ in Japan are still limited. The aim of this study was to determine the effect of ER on survival and occurrence of metachronous cancer of patients with superficial AEGJ. METHODS A retrospective analysis of patients who underwent or endoscopic submucosal dissection (ESD) for superficial AEJG in 13 centers in Japan was performed. The patients were classified as either low risk or high risk for lymph node metastasis based on histologic features. The incidence of metachronous AEGJ as well as overall survival and disease-specific survival rates were calculated. RESULTS A total of 372 patients who underwent ER were included, in which 277 patients were low risk and 95 high risk for lymph node metastasis. Five-year cumulative incidences of local recurrence were 13% and .5% in the EMR and ESD groups, respectively (P < .01). Six AEGJ deaths were observed in the high-risk group and none in the low-risk group. The 5-year overall survival rates in the low-risk group without additional treatment, the high-risk group with additional treatment, and the high-risk group without additional treatment were 93.9%, 77.7%, and 81.6%, respectively. The 5-year disease-specific survival rates in the 3 groups were 100%, 94.4%, and 92.8%, respectively. The 5-year cumulative incidence of metachronous AEGJ in 316 patients without additional treatment was 1.1%. CONCLUSIONS Favorable long-term outcomes with ER were observed in patients with AEGJ who met the low-risk criteria for lymph node metastasis. ESD was a reasonable and effective treatment in Japanese patients.

中文翻译：

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日本食管胃交界处腺癌的内镜切除术后内镜切除和异时性癌症的长期结果。

背景与目的食管胃交界浅表腺癌（AEGJ）的内镜下切除术（ER）已被证明是安全有效的。但是，在日本接受浅表AEGJ ER治疗的患者的长期数据仍然有限。这项研究的目的是确定ER对浅表AEGJ患者生存和异时性癌症发生的影响。方法回顾性分析了日本13个中心接受或经内镜黏膜下剥离术（ESD）进行浅表性AEJG的患者。根据组织学特征，将患者分为淋巴结转移的低风险或高风险。计算了异时AEGJ的发生率以及总生存率和疾病特异性生存率。结果总共纳入了372例接受ER的患者，其中277例发生淋巴结转移的风险较低，而95例发生转移的风险较高。EMR和ESD组的五年局部复发累积发生率分别为13％和0.5％（P <.01）。高危组中有6例AEGJ死亡，低危组中无1例死亡。不加治疗的低风险组，不加治疗的高危组和不加治疗的高危组的5年总生存率分别为93.9％，77.7％和81.6％。3组的5年疾病特异性生存率分别为100％，94.4％和92.8％。316例未经进一步治疗的异时AEGJ的5年累积发生率是1.1％。结论在满足低风险淋巴结转移标准的AEGJ患者中，ER的长期疗效良好。在日本患者中，ESD是一种合理而有效的治疗方法。