Prognostic factors in clinicopathology of oesophagogastric adenocarcinoma: a single-centre longitudinal study of 347 cases over a 20-year period

IF 3.6 3区医学 Q1 PATHOLOGY

Pathology Pub Date : 2024-02-27 DOI:10.1016/j.pathol.2023.12.418

Qin Huang , Edward Lew , Yuqing Cheng , Kevin Huang , Vikram Deshpande , Shweta Shinagare , Xin Yuan , Jason S. Gold , Daniel Wiener , H. Christian Weber

{"title":"Prognostic factors in clinicopathology of oesophagogastric adenocarcinoma: a single-centre longitudinal study of 347 cases over a 20-year period","authors":"Qin Huang , Edward Lew , Yuqing Cheng , Kevin Huang , Vikram Deshpande , Shweta Shinagare , Xin Yuan , Jason S. Gold , Daniel Wiener , H. Christian Weber","doi":"10.1016/j.pathol.2023.12.418","DOIUrl":null,"url":null,"abstract":"<div>Oesophagogastric adenocarcinoma (EGA) includes oesophageal (EA), gastro-oesophageal junctional (GEJA), and gastric (GA) adenocarcinomas. The prognostic values of clinicopathological factors in these tumours remain obscure, especially for GEJA that has been inconsistently classified and staged. We studied the prognosis of EGA patients among the three geographic groups in 347 consecutive patients with a median age of 70 years (range 47–94). All patients were male, and 97.1% were white. Based on tumour epicentre location, EGAs were sub-grouped into EA (over 2 cm above the GEJ; n=3, 18.1%), GEJA (within 2 cm above and 3 cm below the GEJ; n=231, 66.6%), and GA (over 3 cm below the GEJ; n=53, 15.3%). We found that the median overall survival (OS) was the longest in EA (62.9 months), compared to GEJA (33.4), and GA (38.1) (p<0.001). Significant risk factors for OS included tumour location (p=0.018), size (p<0.001), differentiation (p<0.001), adenocarcinoma subtype (p<0.001), and TNM stage (p<0.001). Independent risk factors for OS comprised low-grade papillary adenocarcinoma [odds ratio (OR) 0.449, 95% confidence interval (CI) 0.214–0.944, p<0.05), mixed adenocarcinoma (OR 1.531, 95% CI 1.056–2.218, p<0.05), adenosquamous carcinoma (OR 2.206, 95% CI 1.087–4.475, p<0.05), N stage (OR 1.505, 95% CI 1.043–2.171, p<0.05), and M stage (OR 10.036, 95% CI 2.519–39.993, p=0.001)]. EGA was further divided into low-risk (common well-moderately differentiated tubular and low-grade papillary adenocarcinomas) and high-risk (uncommon adenocarcinoma subtypes, adenosquamous carcinoma) subgroups. In this grouping, the median OS was significantly longer in the low-risk (83 months) than in the high-risk (10 months) subgroups (p<0.001). In conclusion, the prognosis of EGA patients was significantly better in EA than in GEJA or GA and could be stratified into low and high-risk subgroups with significantly different outcomes.</div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0031302524000813","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PATHOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Oesophagogastric adenocarcinoma (EGA) includes oesophageal (EA), gastro-oesophageal junctional (GEJA), and gastric (GA) adenocarcinomas. The prognostic values of clinicopathological factors in these tumours remain obscure, especially for GEJA that has been inconsistently classified and staged. We studied the prognosis of EGA patients among the three geographic groups in 347 consecutive patients with a median age of 70 years (range 47–94). All patients were male, and 97.1% were white. Based on tumour epicentre location, EGAs were sub-grouped into EA (over 2 cm above the GEJ; n=3, 18.1%), GEJA (within 2 cm above and 3 cm below the GEJ; n=231, 66.6%), and GA (over 3 cm below the GEJ; n=53, 15.3%). We found that the median overall survival (OS) was the longest in EA (62.9 months), compared to GEJA (33.4), and GA (38.1) (p<0.001). Significant risk factors for OS included tumour location (p=0.018), size (p<0.001), differentiation (p<0.001), adenocarcinoma subtype (p<0.001), and TNM stage (p<0.001). Independent risk factors for OS comprised low-grade papillary adenocarcinoma [odds ratio (OR) 0.449, 95% confidence interval (CI) 0.214–0.944, p<0.05), mixed adenocarcinoma (OR 1.531, 95% CI 1.056–2.218, p<0.05), adenosquamous carcinoma (OR 2.206, 95% CI 1.087–4.475, p<0.05), N stage (OR 1.505, 95% CI 1.043–2.171, p<0.05), and M stage (OR 10.036, 95% CI 2.519–39.993, p=0.001)]. EGA was further divided into low-risk (common well-moderately differentiated tubular and low-grade papillary adenocarcinomas) and high-risk (uncommon adenocarcinoma subtypes, adenosquamous carcinoma) subgroups. In this grouping, the median OS was significantly longer in the low-risk (83 months) than in the high-risk (10 months) subgroups (p<0.001). In conclusion, the prognosis of EGA patients was significantly better in EA than in GEJA or GA and could be stratified into low and high-risk subgroups with significantly different outcomes.

查看原文本刊更多论文

食管胃腺癌临床病理学的预后因素：20 年间 347 例病例的单中心纵向研究

食管胃腺癌（EGA）包括食管腺癌（EA）、胃食管交界腺癌（GEJA）和胃腺癌（GA）。这些肿瘤的临床病理因素的预后价值仍不明确，尤其是 GEJA 的分类和分期不一致。我们研究了 347 例连续患者中三个地域组别中 EGA 患者的预后，这些患者的中位年龄为 70 岁（47-94 岁）。所有患者均为男性，97.1%为白人。根据肿瘤震中位置，EGAs被细分为EA（GEJ上方2厘米以上；=3，18.1%）、GEJA（GEJ上方和下方2厘米以内；=231，66.6%）和GA（GEJ下方3厘米以上；=53，15.3%）。我们发现，与 GEJA（33.4 个月）和 GA（38.1 个月）相比，EA 的中位总生存期（OS）最长（62.9 个月）（<0.001）。OS的重要风险因素包括肿瘤位置（=0.018）、大小（<0.001）、分化（<0.001）、腺癌亚型（<0.001）和TNM分期（<0.001）。OS的独立风险因素包括低级别乳头状腺癌（几率比（OR）0.449，95%置信区间（CI）0.214-0.944，<0.05）、混合型腺癌（OR 1.531，95% CI 1.056-2.218，<0.05）、腺鳞癌（OR 2.206，95% CI 1.087-4.475，<0.05）、N 期（OR 1.505，95% CI 1.043-2.171，<0.05）和 M 期（OR 10.036，95% CI 2.519-39.993，=0.001）]。EGA进一步分为低危（常见的中度分化良好的管状腺癌和低级别乳头状腺癌）和高危（不常见的腺癌亚型、腺鳞癌）亚组。在这一分组中，低风险亚组的中位生存期（83个月）明显长于高风险亚组（10个月）（<0.001）。总之，EGA患者的预后在EA中明显优于GEJA或GA，并可分为低风险亚组和高风险亚组，其预后明显不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pathology 医学-病理学

CiteScore

6.50

自引率

2.20%

发文量

459

审稿时长

54 days

期刊介绍： Published by Elsevier from 2016 Pathology is the official journal of the Royal College of Pathologists of Australasia (RCPA). It is committed to publishing peer-reviewed, original articles related to the science of pathology in its broadest sense, including anatomical pathology, chemical pathology and biochemistry, cytopathology, experimental pathology, forensic pathology and morbid anatomy, genetics, haematology, immunology and immunopathology, microbiology and molecular pathology.