The Prognostic Value Of The Number Of Negative Lymph Nodes In Siewert Type â…¡ Adenocarcinoma Of The Esophagogastric Junction(AEG) Without Lymphatic Metastasis After Surgery

Objective To investigate the correlation between the number of resected lymph nodes(LNs) and the prognosis of patients with node-negative Siewert Type II AEG..Methods 248 patients with Siewert Type II AEG treated in our institution between January 1998 and December 2008 were retrospectively assessed. All cases undergone the left transthoracic subtotal esophagectomy and proximal gastrectomy approach with conventional two-field lymphadenectomy were proved without lymph node involvement histopathologically. The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed.Results The overall median survival time and the 1-,3-,and 5-year overall survival rates were 64.0 months,80.4%, 60.8% and 51.0%,respectively. Survival analysis confirmed that the number of negative LNs and the depth of tumor invasion were showed to be independent prognostic factors. Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs(P<0.05).The patients had better long-term survival outcomes with dissected LNs counts of more than 10 for cases with p T1 tumor(P =0.000),and more than 15 for cases with p T2-3 tumor(P =0.003,0.018,respectively).Conclusion The number of negative lymph nodes and the depth of tumor invasion are independent prognostic factors for node-negative Siewert Type II AEG, a certain number of lymph nodes dissection can improve long-term survival.