Journal
DIGESTIVE SURGERY
Volume 33, Issue 5, Pages 424-430Publisher
KARGER
DOI: 10.1159/000444457
Keywords
Esophago-gastric; Junction; Neoadjuvant chemotherapy; Surgery
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Funding
- Epidemiological and Clinical Research Information Network (ECRIN)
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Background: It was unclear whether the transhiatal approach and D2 total gastrectomy after neoadjuvant chemotherapy (NAC) for adenocarcinoma of the esophago-gastric (AEG) junction are as feasible and safe as D2 gastrectomy following NAC. Patients and Methods: We clarified the short-term surgical results in AEG and non-AEG patients in a subset analysis of the COMPASS trial. Results: Eighty-three patients, 24 with AEG and 59 with non-AEG, were registered in the study. Among 24 patients with AEG, 5 were classified to have Siewert type I, 11 to have type II and 8 to have type III. The tumor progression, completion of NAC, and clinical and pathological responses were similar between the groups. Twenty-four AEG and 51 non-AEG patients proceeded to surgery. The extent of dissection (D1/D2) was 3/21 in the AEG and 3/48 in the non-AEG patients. The R0 resection rate was 69% in the non-AEG and 88% in the AEG patients. Neither grade 3b/4 morbidity nor surgical mortality was observed in either group. Conclusions: The transhiatal approach and D2 total gastrectomy after NAC seem to be as safe and feasible as D2 gastrectomy for non-AEG cancer. (C) 2016 S. Karger AG, Basel
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