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01-01-2021 | Adenocarcinoma of the Esophagogastric Junction

Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction

Authors: Shizuki Sugita, Takahiro Kinoshita, Takeshi Kuwata, Masanori Tokunaga, Akio Kaito, Masahiro Watanabe, Akiko Tonouchi, Reo Sato, Masato Nagino

Published in: Surgical Endoscopy | Issue 1/2021

Abstract

Background

Insufficient information is available about the long-term outcomes of patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) who undergo laparoscopic transhiatal approach (LTH). Here we evaluated the oncological safety of LTH for patients with Siewert type II AEG compared with the open transhiatal approach (OTH).

Methods

Subjects included 79 patients with Siewert type II AEG who underwent gastrectomy combined with lower esophagectomy from 2008 to 2018 at our institution. Overall survival (OS), recurrence-free survival (RFS), status of adjuvant chemotherapy, late-phase complications, and recurrence patterns were compared between the OTH (n = 29) and LTH groups (n = 43).

Results

The median observation periods were 60 months (6–120 months) and 36 months (1–88) for the OTH and LTH groups, respectively. The 5-year OS rates were significantly different: 74% (95% CI 71–77%) and 98% (95% CI 97–99) in the OTH and LTH groups (HR 0.10, 95% CI 0.01–0.83), respectively, though the OTH group included more patients with advanced disease. After stratification, according to pathological stage to adjust for selection bias, the 5-year OS and RFS rates were longer, but not significantly different among patients in the LTH group with pStage III (HR 0.42, 95% CI 0.05–3.47; HR 0.47, 95% CI 0.10–2.12, respectively). Recurrence patterns were similar in the both groups.

Conclusions

Long-term outcomes of the LTH group were not inferior to those of the OTH group, suggesting the possibility of LTH as a treatment option for selected patients with Siewert type II AEG.

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Title: Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction
Authors: Shizuki Sugita
Takahiro Kinoshita
Takeshi Kuwata
Masanori Tokunaga
Akio Kaito
Masahiro Watanabe
Akiko Tonouchi
Reo Sato
Masato Nagino
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Adenocarcinoma of the Esophagogastric Junction
Gastroesophageal Junction Cancer
Gastrectomy
Gastrectomy
Cytostatic Therapy
Published in: Surgical Endoscopy / Issue 1/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07406-w

At a glance: The STEP trials

Springer Medicine

Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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