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Two Different Surgical Approaches in the Treatment of Adenocarcinoma at the Gastroesophageal Junction.

Johansson, Jan LU ; Djerf, Pauline LU ; Öberg, Stefan LU ; Zilling, Thomas LU ; von Holstein, Christer; Johnsson, Folke LU and Walther, Bruno LU (2008) In World Journal of Surgery 32. p.1013-1020
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
World Journal of Surgery
volume
32
pages
1013 - 1020
publisher
Springer
external identifiers
  • PMID:18299921
  • WOS:000256036900011
  • Scopus:43949117753
ISSN
1432-2323
DOI
10.1007/s00268-008-9470-7
language
English
LU publication?
yes
id
5f5b4f81-865d-4e4b-bc21-f45b9bbcda35 (old id 1041516)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18299921?dopt=Abstract
date added to LUP
2008-03-06 11:36:49
date last changed
2016-10-13 04:25:44
@misc{5f5b4f81-865d-4e4b-bc21-f45b9bbcda35,
  abstract     = {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.},
  author       = {Johansson, Jan and Djerf, Pauline and Öberg, Stefan and Zilling, Thomas and von Holstein, Christer and Johnsson, Folke and Walther, Bruno},
  issn         = {1432-2323},
  language     = {eng},
  pages        = {1013--1020},
  publisher    = {ARRAY(0x5070ce0)},
  series       = {World Journal of Surgery},
  title        = {Two Different Surgical Approaches in the Treatment of Adenocarcinoma at the Gastroesophageal Junction.},
  url          = {http://dx.doi.org/10.1007/s00268-008-9470-7},
  volume       = {32},
  year         = {2008},
}