This study was institutionally approved by the Kyoto Prefectural University of Medicine, and each participant provided written informed consent. A total of 117 patients who underwent curative surgery for AEG, classified as Siewert type I or II, at our institute between 2000 and 2016 were included in this study. We precisely defined Siewert type based on pathological mapping and macroscopic measurements of the distance between the tumour epicentre and the esophagogastric junction. Furthermore, we retrospectively analysed clinicopathological features and prognostic outcomes. Finally, we evaluated the compatibility of our findings with the eighth edition of the AJCC/UICC TNM classification system for AEG [7 , 15 ].
The postoperative follow-up program at our institution comprises a regular physical examination as well as laboratory blood tests and chest X-rays every three or six months. Endoscopy and ultrasonography, or computed tomography, were performed annually for the first five years, if possible. All enrolled patients underwent pathological or macroscopic curative resection (R0). Histological types were classified as differentiated (papillary adenocarcinoma, or moderately or well-differentiated adenocarcinoma) or undifferentiated (poorly differentiated or undifferentiated adenocarcinoma, signet-ring cell carcinoma, or mucinous adenocarcinoma) based on the 15th edition of the Japanese Classification of Gastric Carcinoma [16 ]. Patients with bulky metastatic lymph nodes underwent neoadjuvant chemotherapy (NAC). The regimen of NAC was S-1 and cisplatin according to Japanese gastric cancer guidelines [16 ]. Patients who underwent NAC were 10.2% (12/117) of all patients. Patients with pStage II or high underwent postoperative S-1 adjuvant chemotherapy for one year according to the ACTS-GC (Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer) study [17 (link)].
The postoperative follow-up program at our institution comprises a regular physical examination as well as laboratory blood tests and chest X-rays every three or six months. Endoscopy and ultrasonography, or computed tomography, were performed annually for the first five years, if possible. All enrolled patients underwent pathological or macroscopic curative resection (R0). Histological types were classified as differentiated (papillary adenocarcinoma, or moderately or well-differentiated adenocarcinoma) or undifferentiated (poorly differentiated or undifferentiated adenocarcinoma, signet-ring cell carcinoma, or mucinous adenocarcinoma) based on the 15th edition of the Japanese Classification of Gastric Carcinoma [16 ]. Patients with bulky metastatic lymph nodes underwent neoadjuvant chemotherapy (NAC). The regimen of NAC was S-1 and cisplatin according to Japanese gastric cancer guidelines [16 ]. Patients who underwent NAC were 10.2% (12/117) of all patients. Patients with pStage II or high underwent postoperative S-1 adjuvant chemotherapy for one year according to the ACTS-GC (Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer) study [17 (link)].
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