BACKGROUND: Adenocarcinoma at the gastroesophageal junction may be regarded as of esophageal or of gastric origin, and tumor removal may follow the principles of esophagectomy or extended gastrectomy. We determined the impact of this strategy on our patients with tumors at this site. METHODS: Baseline patient and tumor characteristics were collected, and tumors were categorized according to Siewert's classification (I, II, or III) of gastroesophageal junction tumors. Totally, 133 patients were operated on between 1990 and 2001. Ninety-six patients with type I (n = 67), II (n = 26), and III (n = 3) tumors underwent esophagectomy and gastric tube reconstruction, and 37 patients with type I (n = 5), II (n = 26), and III (n = 6) tumors underwent extended gastrectomy and long Roux-en-Y reconstructions. RESULTS: After adjusting for the independently significant impact factors-tumor stage, tumor dissection (R0-R2), and length of tumor free resection margins-we did not find any specific survival benefit associated with either of the two evaluated surgical approaches for tumor resection and reconstruction. The EORTC quality of life forms revealed good results as indicated by the functional scales and the symptom scales. CONCLUSIONS: Provided that adequate tumor dissection is performed, patients with adenocarcinoma at the gastroesophageal junction can be resected and reconstructed using the principles for esophagectomy or extended gastrectomy.
BACKGROUND:Adenocarcinoma at the gastroesophageal junction may be regarded as of esophageal or of gastric origin, and tumor removal may follow the principles of esophagectomy or extended gastrectomy. We determined the impact of this strategy on our patients with tumors at this site. METHODS: Baseline patient and tumor characteristics were collected, and tumors were categorized according to Siewert's classification (I, II, or III) of gastroesophageal junction tumors. Totally, 133 patients were operated on between 1990 and 2001. Ninety-six patients with type I (n = 67), II (n = 26), and III (n = 3) tumors underwent esophagectomy and gastric tube reconstruction, and 37 patients with type I (n = 5), II (n = 26), and III (n = 6) tumors underwent extended gastrectomy and long Roux-en-Y reconstructions. RESULTS: After adjusting for the independently significant impact factors-tumor stage, tumor dissection (R0-R2), and length of tumor free resection margins-we did not find any specific survival benefit associated with either of the two evaluated surgical approaches for tumor resection and reconstruction. The EORTC quality of life forms revealed good results as indicated by the functional scales and the symptom scales. CONCLUSIONS: Provided that adequate tumor dissection is performed, patients with adenocarcinoma at the gastroesophageal junction can be resected and reconstructed using the principles for esophagectomy or extended gastrectomy.
Authors: Andrew P Barbour; Nabil P Rizk; Mithat Gonen; Laura Tang; Manjit S Bains; Valerie W Rusch; Daniel G Coit; Murray F Brennan Journal: Ann Surg Oncol Date: 2006-11-08 Impact factor: 5.344
Authors: T Lerut; P Nafteux; J Moons; W Coosemans; G Decker; P De Leyn; D Van Raemdonck; N Ectors Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: Jan B F Hulscher; Johanna W van Sandick; Angela G E M de Boer; Bas P L Wijnhoven; Jan G P Tijssen; Paul Fockens; Peep F M Stalmeier; Fiebo J W ten Kate; Herman van Dekken; Huug Obertop; Hugo W Tilanus; J Jan B van Lanschot Journal: N Engl J Med Date: 2002-11-21 Impact factor: 91.245
Authors: N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes Journal: J Natl Cancer Inst Date: 1993-03-03 Impact factor: 13.506
Authors: Andrew P Barbour; Nabil P Rizk; Mithat Gonen; Laura Tang; Manjit S Bains; Valerie W Rusch; Daniel G Coit; Murray F Brennan Journal: Ann Surg Date: 2007-07 Impact factor: 12.969
Authors: Bala Başak Öven Ustaalioğlu; Metin Tilki; Ali Sürmelioğlu; Ahmet Bilici; Can Gönen; Recep Ustaalioğlu; Özlem Balvan; Mehmet Aliustaoğlu Journal: Turk J Surg Date: 2017-03-01
Authors: Susanne Blank; Thomas Schmidt; Patrick Heger; Moritz J Strowitzki; Leila Sisic; Ulrike Heger; Henrik Nienhueser; Georg Martin Haag; Thomas Bruckner; André L Mihaljevic; Katja Ott; Markus W Büchler; Alexis Ulrich Journal: Gastric Cancer Date: 2017-07-06 Impact factor: 7.370