Analysis Of Risk Factors For Adenocarcinoma Of Esophagogastric Junction And Colon Cancer

Chapter 1 Explore the risk factor of tumor recurrence metastasis in adenocarcinoma of the esophagogastric junction Siewert Ⅱ/Ⅲ after radical resectionObjective:To the risk factor of tumor recurrence metastasis within 5 years in adenocarcinoma of the esophagogastric junction(AEG)Siewert Ⅱ/Ⅲ after radical resection.Methods:We retrospectively analyzed the Siewert Ⅱ/Ⅲ AEG patients in Guangdong Provincial Hospital of General surgery and Thoracic surgery in November 2004 to 2014 who underwent a radical resection and have complete clinical data.Results:A total of 155 patients were included in the study,of which 96 had no recurrence and metastasis within 5 years after radical resection,and 59 had recurrence and metastasis within 5 years.The recurrence and metastasis rate within 5 years was 40.2%,and multivariate logistic regression analysis results showed that N stage,is Siewert Ⅱ/Ⅲ AEG after radical resection independent risk factors for recurrence and metastasis within 5 years.Conclusions:N staging are Siewert Ⅱ/Ⅲ AEG after radical resection independent risk factors for recurrence and metastasis within 5 years.Chapter 2 Relation between tumor size and lymph node metastasis in stages T1-T3 of Siewert type Ⅱ adenocarcinoma of esophagogastric junctionObjective:The relationship between tumor size(Ts)and lymph node metastasis(LNM)is unclear.Methods:Data from 4649 Siewert type Ⅱ AEG patients were retrospectively acquired from the Surveillance,Epidemiology,and End Result(SEER)database.The logistic regression model and restricted cubic spline(RCS)model was used to explore the relationship between Ts and LNM,after adjusting for covariates.Results:Ts and LNM showed a significant relationship in the logistic regression analysis,regardless of the Ts data being entered as a continuous or a categorical variable,after adjusting for covariates.The logistic regression model and RCS consistently showed that larger Ts resulted in larger Odds Ratio(OR)values.When tumors were larger than 4 cm,the OR value remained relatively constant.Conclusions:In Siewert type Ⅱ T1-T3 stage AEG patients,we reported that LNM increased with Ts up to 4 cm.Chapter 3 Association of tumor size with prognosis in colon cancerObjective:In colon cancer(CC),the association of Ts and prognosis remained unclear.Methods:We selected 128369 patients with CC who underwent surgery from SEER database.Overall survival(OS)and cancer-specific survival(CSS)were separately analyzed,and Ts was separately compared as a continuous and categorical variable.To investigate the relation after adjusted covariations,we used Cox model.The restricted cubic spline(RCS)model was applied to explore non-linear or linear association.Results:The adjusted covariate model showed that(hazard ratio)HR of CC rapidly increased with larger Ts in 4 cm and slowly increased beyond 4 cm.The subgroup analysis by LNM illustrated that the relation was obvious in LNM.Conclusions:The findings indicated a strong negative relation between Ts and prognosis in CC.However,when Ts was in 4cm,the relationship between Ts and prognosis was steep relative to after 4cm,especially for LNM.