Roman Stürzl1, Michael Gerken2,3, Christiane Bruns4, Monika Klinkhammer-Schalke2,3, Armin Pauer2,3, Pompiliu Piso5. 1. Tumorzentrum, Institut für Qualitätssicherung und Versorgungsforschung, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. roman.stuerzl@stud.uni-regensburg.de. 2. Tumorzentrum, Institut für Qualitätssicherung und Versorgungsforschung, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. 3. Bayrisches Krebsregister, Regionalzentrum Regensburg, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Regensburg, Deutschland. 4. Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland. 5. Klinik für Allgemein- und Viszeralchirurgie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland.
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.
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.
Authors: Philip Baum; Johannes Diers; Sven Lichthardt; Carolin Kastner; Nicolas Schlegel; Christoph-Thomas Germer; Armin Wiegering Journal: Dtsch Arztebl Int Date: 2019-11-01 Impact factor: 5.594
Authors: Jessica M Leers; Laura Knepper; Arjen van der Veen; Wolfgang Schröder; Hans Fuchs; Petra Schiller; Martin Hellmich; Ulrike Zettelmeyer; Lodewijk A A Brosens; Alexander Quaas; Jelle P Ruurda; Richard van Hillegersberg; Christiane J Bruns Journal: BMC Cancer Date: 2020-08-20 Impact factor: 4.430