TY - JOUR
T1 - Gastrectomy Versus Esophagectomy for Gastroesophageal Junction Tumors
T2 - Short- and Long-Term Outcomes From the Dutch Upper Gastrointestinal Cancer Audit
AU - Jezerskyte, Egle
AU - Mertens, Alexander C.
AU - Dieren, Susan van
AU - Eshuis, Wietse J.
AU - Dutch Upper Gastrointestinal Cancer Audit (DUCA) group
AU - Sprangers, Mirjam A. G.
AU - van Berge Henegouwen, Mark I.
AU - Gisbertz, Suzanne S.
N1 - Funding Information: M.i.vBH. has a consultant role with Mylan, Johnson and Johnson, and Medtronic. Research funding from Olympus and Stryker. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Objective: Investigate long-term survival, morbidity, mortality, and pathology results in patients following esophagectomy or total gastrectomy for gastroesophageal junction (GEJ) cancer. Background: Both a total gastrectomy and an esophagectomy may be valid treatment options in patients with GEJ cancer. Which procedure results in the most optimal patient outcome is not well studied. The aim of this study was to investigate the long-term survival, morbidity, mortality, and pathology results in patients following esophagectomy or total gastrectomy for GEJ cancer. Methods: A retrospective comparative cohort study of prospectively collected data from the Dutch Upper GI Cancer Audit combined with survival data of the Dutch medical insurance database was performed. Patients with GEJ cancer in whom a total gastrectomy or an esophagectomy was performed between 2011 and 2016 were compared. The primary outcome was 3-year overall survival. Postoperative morbidity, mortality, 3-year conditional survival, radicality of resection, and lymph node yield were secondary endpoints. Results: A total of 871 patients were included: 790 following esophagectomy and 81 following gastrectomy. The 3-year overall survival was 35.8% after esophagectomy and 28.4% after gastrectomy (hazard ratio 1.2, 95% confidence interval 0.721-1.836, P = 0.557). Postoperative morbidity, mortality, radicality of resection, lymph node yield, and 3-year conditional survival did not differ significantly between groups. Conclusion: A total gastrectomy and an esophagectomy for GEJ cancer show largely comparable results with regard to long-term survival, postoperative morbidity, mortality, and pathology results. If both procedures are feasible, other parameters such as surgeona s experience and quality of life should be considered when planning for surgery.
AB - Objective: Investigate long-term survival, morbidity, mortality, and pathology results in patients following esophagectomy or total gastrectomy for gastroesophageal junction (GEJ) cancer. Background: Both a total gastrectomy and an esophagectomy may be valid treatment options in patients with GEJ cancer. Which procedure results in the most optimal patient outcome is not well studied. The aim of this study was to investigate the long-term survival, morbidity, mortality, and pathology results in patients following esophagectomy or total gastrectomy for GEJ cancer. Methods: A retrospective comparative cohort study of prospectively collected data from the Dutch Upper GI Cancer Audit combined with survival data of the Dutch medical insurance database was performed. Patients with GEJ cancer in whom a total gastrectomy or an esophagectomy was performed between 2011 and 2016 were compared. The primary outcome was 3-year overall survival. Postoperative morbidity, mortality, 3-year conditional survival, radicality of resection, and lymph node yield were secondary endpoints. Results: A total of 871 patients were included: 790 following esophagectomy and 81 following gastrectomy. The 3-year overall survival was 35.8% after esophagectomy and 28.4% after gastrectomy (hazard ratio 1.2, 95% confidence interval 0.721-1.836, P = 0.557). Postoperative morbidity, mortality, radicality of resection, lymph node yield, and 3-year conditional survival did not differ significantly between groups. Conclusion: A total gastrectomy and an esophagectomy for GEJ cancer show largely comparable results with regard to long-term survival, postoperative morbidity, mortality, and pathology results. If both procedures are feasible, other parameters such as surgeona s experience and quality of life should be considered when planning for surgery.
KW - esophagectomy
KW - esophagogastric junction
KW - gastrectomy
KW - lymph nodes
KW - morbidity
KW - mortality
KW - pathology
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85141893882&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/SLA.0000000000004610
DO - https://doi.org/10.1097/SLA.0000000000004610
M3 - Article
C2 - 33214453
SN - 0003-4932
VL - 276
SP - e735-e743
JO - Annals of surgery
JF - Annals of surgery
IS - 6
ER -