[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-384224-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-384224-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","independent-stage-classification-for-gastroesophageal-junction-adenocarcinoma","Independent Stage Classification for Gastroesophageal Junction Adenocarcinoma","","Gastroesophageal junction (GEJ) adenocarcinoma prognosis based on ypTNM staging can be influenced by preoperative therapy. Using the National Cancer Database, patients who received preoperative therapy followed by curative-intent surgery between 2006 and 2017 were identified and analyzed across four gross ypTNM groups (ypT1/2 N0, ypT1/2 N+, ypT3/4 N0, ypT3/4 N+). Among 25,463 records, GEJ cohorts showed distinct overall survival patterns compared with other esophageal or gastric cancers. Cox regression indicated preoperative chemoradiotherapy associated with shorter OS than chemotherapy after ypTNM adjustment, and a tailored nomogram achieved a concordance index of 0.833, supporting regimen-inclusive OS prediction with further validation needed.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/independent-stage-classification-for-gastroesophageal-junction-adenocarcinoma/384224/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/independent-stage-classification-for-gastroesophageal-junction-adenocarcinoma/384224.png","ImageObject",300,407,{"name":42,"@type":43},"4398046744996","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How does preoperative therapy affect prognosis in GEJ adenocarcinoma?","Question",{"text":63,"@type":64},"The study reports that overall survival based on ypTNM staging can vary depending on the preoperative therapy received.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What staging framework did the study use for stage-by-stage comparisons?",{"text":68,"@type":64},"Tumors were classified into four gross ypTNM groups: ypT1/2 N-negative, ypT1/2 N-positive, ypT3/4 N-negative, and ypT3/4 N-positive.",{"name":70,"@type":61,"acceptedAnswer":71},"What was the main finding regarding overall survival between chemoradiotherapy and chemotherapy?",{"text":72,"@type":64},"After adjustment for the ypTNM group, preoperative chemoradiotherapy was associated with shorter overall survival than preoperative chemotherapy, with an identified hazard ratio and significant p-value.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},384224,1790293666,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":11,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":138,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},4398046744996,"cancers   \nArticle  \nIndependent Stage Classification for Gastroesophageal Junction Adenocarcinoma  \nYuki Hirata 1, Yi-Ju Chiang 1, Jeannelyn S. Estrella 2, Prajnan Das 3, Bruce D. Minsky 3, Mariela Blum Murphy 4, Jaffer A. Ajani 4, Paul Mansfield 1, Brian D. Badgwell 1 and Naruhiko Ikoma 1, *  \nCitation: Hirata, Y.; Chiang, Y.-J.; Estrella, J.S.; Das, P.; Minsky, B.D.; Blum Murphy, M.; Ajani, J.A.; Mansfield, P.; Badgwell, B.D.; Ikoma, N. Independent Stage Classification for Gastroesophageal Junction Adenocarcinoma. Cancers 2023, 15, 5137. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15215137  \nAcademic Editors: Kazuo Koyanagi and Yoshiaki Shoji  \nReceived: 1 August 2023  \nRevised: 15 August 2023  \nAccepted: 2 October 2023  \nPublished: 25 October 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; [yhirata@mdanderson.org](yhirata@mdanderson.org) (Y.H.); [ychiang1@mdanderson.org](ychiang1@mdanderson.org) (Y.-J.C.); pmansfi[e@mdanderson.org](e@mdanderson.org) (P.M.); [bbadgwell@mdanderson.org](bbadgwell@mdanderson.org) (B.D.B.)  \n2 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; [jsestrella@mdanderson.org](jsestrella@mdanderson.org)  \n3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; [prajdas@mdanderson.org](prajdas@mdanderson.org) (P.D.); [bminsky@mdanderson.org](bminsky@mdanderson.org) (B.D.M.)  \n4 Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; [mblum1@mdanderson.org](mblum1@mdanderson.org) (M.B.M.); [jajani@mdanderson.org](jajani@mdanderson.org) (J.A.A.)  \n* [Correspondence: nikoma@mdanderson.org](Correspondence: nikoma@mdanderson.org); Tel.: +1-(713)-563-2354  \nSimple Summary: In gastroesophageal junction (GEJ) adenocarcinoma cases, a prognosis based on ypTNM staging could be affected by preoperative therapy. In this study, we investigated 11,340 patients with GEJ adenocarcinoma who received preoperative therapy followed by curativeintent surgery and examined the clinicopathologic factors associated with overall survival (OS) . We found that median OS durations in patients with GEJ adenocarcinoma, when sorted by stage, were substantially different from those of patients with adenocarcinoma of the upper or middle esophagus or of the non-cardia stomach. Additionally, preoperative chemoradiotherapy (CXRT) was associated with lower OS rates than chemotherapy after adjustment for the ypT and ypN categories. These results indicate that we should develop an independent GEJ staging system, rather than separating GEJ cancers into either esophageal or gastric cancers and using those staging systems, for better OS prediction. The OS prediction nomogram developed in this study, which included a preoperative therapy regimen, provided reasonable OS prediction.  \nAbstract: In gastroesophageal junction (GEJ) adenocarcinoma cases, a prognosis based on ypTNM staging could be affected by preoperative therapy. Patients with esophageal adenocarcinoma and gastric adenocarcinoma who underwent preoperative therapy followed by surgical resection from 2006 through 2017 were identified in the National Cancer Database. To enable stage-by-stage OS comparisons, tumors were classified into four gross ypTNM groups: ypT1/2, N-negative; ypT1/2, N-positive; ypT3/4, N-negative; and ypT3/4, N-positive. Prognostic factors were examined, and an OS prediction nomogram was developed for patients with abdominal/lower esophagea","cbCaia0XPFNOToCq","https://ap.wps.com/l/cbCaia0XPFNOToCq","pdf",1298575,13,"English","# Introduction\n## Study background and staging controversy for GEJ adenocarcinoma\n## AJCC (eighth edition) staging approach using tumor epicenter","[{\"question\":\"How does preoperative therapy affect prognosis in GEJ adenocarcinoma?\",\"answer\":\"The study reports that overall survival based on ypTNM staging can vary depending on the preoperative therapy received.\"},{\"question\":\"What staging framework did the study use for stage-by-stage comparisons?\",\"answer\":\"Tumors were classified into four gross ypTNM groups: ypT1/2 N-negative, ypT1/2 N-positive, ypT3/4 N-negative, and ypT3/4 N-positive.\"},{\"question\":\"What was the main finding regarding overall survival between chemoradiotherapy and chemotherapy?\",\"answer\":\"After adjustment for the ypTNM group, preoperative chemoradiotherapy was associated with shorter overall survival than preoperative chemotherapy, with an identified hazard ratio and significant p-value.\"}]","Independent Stage Classification for Gastroesophageal Junction Adenocarcinoma | PDF",1790261751,33]