Surgical treatment of adenocarcinoma of the esophagogastric junction type II Comparison between transhiatal extended gastrectomy and thoracoabdominal esophagectomy

Stuerzl, Roman, Gerken, Michael, Bruns, Christiane, Klinkhammer-Schalke, Monika, Pauer, Armin and Piso, Pompiliu . Surgical treatment of adenocarcinoma of the esophagogastric junction type II Comparison between transhiatal extended gastrectomy and thoracoabdominal esophagectomy. Chirurgie. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 2731-698X

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DOI:10.1007/s00104-022-01703-x

Abstract

Background The incidence of adenocarcinoma of the esophagogastric junction (AEG) has significantly increased. However, the best surgical treatment for AEG type II is still the subject of current research. The goal of this retrospective cohort study is to compare survival and recurrence rates in patients, who underwent either thoracoabdominal esophagectomy (TAE) or transhiatal extended gastrectomy (TEG). Material and methods The study is based on a cohort of 272 patients diagnosed with AEG type II between 2002 and 2020, recorded by a population-based clinical cancer registry. Of the included patients 63 underwent TAE and 209 TEG. In order to compare overall survival, recurrence rates, and recurrence free survival, we applied the Kaplan-Meier method, univariable and multivariable Cox regression. Results Our analysis showed no statistically significant difference concerning overall survival (p = 0.333). However a tendency towards higher survival rates after TAE for the period from 2016-2020 (p = 0,058) is possible. In contrast a significant difference concerning higher cumulative recurrence rates after TAE was found after Kaplan-Meier analysis (p = 0.049). This trend was not observed for the time after 2016 (p = 0.993), in which over 50% of TAE were performed. No differences were found regarding recurrence-free survival (p = 0.772). Conclusion Our findings in a rather small cohort are concordant with most studies showing no differences or a trend towards better survival after TAE. Other studies found no significant difference regarding recurrence-free survival as well. In conclusion, no significant differences were found between TEG and TAE in surgical treatment of AEG type II.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Stuerzl, Roman	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Gerken, Michael	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Bruns, Christiane	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Klinkhammer-Schalke, Monika	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Pauer, Armin	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Piso, Pompiliu	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED