Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction.
Adenocarcinoma of the esophagogastric junction
Laparoscopic transhiatal approach
Long-term outcome
Oncological safety
Siewert type II
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
29
05
2019
accepted:
30
01
2020
pubmed:
7
2
2020
medline:
29
6
2021
entrez:
7
2
2020
Statut:
ppublish
Résumé
Insufficient information is available about the long-term outcomes of patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) who undergo laparoscopic transhiatal approach (LTH). Here we evaluated the oncological safety of LTH for patients with Siewert type II AEG compared with the open transhiatal approach (OTH). Subjects included 79 patients with Siewert type II AEG who underwent gastrectomy combined with lower esophagectomy from 2008 to 2018 at our institution. Overall survival (OS), recurrence-free survival (RFS), status of adjuvant chemotherapy, late-phase complications, and recurrence patterns were compared between the OTH (n = 29) and LTH groups (n = 43). The median observation periods were 60 months (6-120 months) and 36 months (1-88) for the OTH and LTH groups, respectively. The 5-year OS rates were significantly different: 74% (95% CI 71-77%) and 98% (95% CI 97-99) in the OTH and LTH groups (HR 0.10, 95% CI 0.01-0.83), respectively, though the OTH group included more patients with advanced disease. After stratification, according to pathological stage to adjust for selection bias, the 5-year OS and RFS rates were longer, but not significantly different among patients in the LTH group with pStage III (HR 0.42, 95% CI 0.05-3.47; HR 0.47, 95% CI 0.10-2.12, respectively). Recurrence patterns were similar in the both groups. Long-term outcomes of the LTH group were not inferior to those of the OTH group, suggesting the possibility of LTH as a treatment option for selected patients with Siewert type II AEG.
Sections du résumé
BACKGROUND
Insufficient information is available about the long-term outcomes of patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) who undergo laparoscopic transhiatal approach (LTH). Here we evaluated the oncological safety of LTH for patients with Siewert type II AEG compared with the open transhiatal approach (OTH).
METHODS
Subjects included 79 patients with Siewert type II AEG who underwent gastrectomy combined with lower esophagectomy from 2008 to 2018 at our institution. Overall survival (OS), recurrence-free survival (RFS), status of adjuvant chemotherapy, late-phase complications, and recurrence patterns were compared between the OTH (n = 29) and LTH groups (n = 43).
RESULTS
The median observation periods were 60 months (6-120 months) and 36 months (1-88) for the OTH and LTH groups, respectively. The 5-year OS rates were significantly different: 74% (95% CI 71-77%) and 98% (95% CI 97-99) in the OTH and LTH groups (HR 0.10, 95% CI 0.01-0.83), respectively, though the OTH group included more patients with advanced disease. After stratification, according to pathological stage to adjust for selection bias, the 5-year OS and RFS rates were longer, but not significantly different among patients in the LTH group with pStage III (HR 0.42, 95% CI 0.05-3.47; HR 0.47, 95% CI 0.10-2.12, respectively). Recurrence patterns were similar in the both groups.
CONCLUSIONS
Long-term outcomes of the LTH group were not inferior to those of the OTH group, suggesting the possibility of LTH as a treatment option for selected patients with Siewert type II AEG.
Identifiants
pubmed: 32025923
doi: 10.1007/s00464-020-07406-w
pii: 10.1007/s00464-020-07406-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
340-348Références
Kusano C, Gotoda T, Khor CJ, Katai H, Kato H, Taniguchi H, Shimoda T (2008) Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan. J Gastroenterol Hepatol 23:1662–1665. https://doi.org/10.1111/j.1440-1746.2008.05572.x
doi: 10.1111/j.1440-1746.2008.05572.x
pubmed: 19120859
Yamashita H, Seto Y, Sano T, Makuuchi H, Ando N, Sasako M, Association OBOTJGC (2016) Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma. Gastric Cancer 20:1–15. https://doi.org/10.1007/s10120-016-0663-8
doi: 10.1007/s10120-016-0663-8
Buas MF, Vaughan TL (2013) Epidemiology and risk factors for gastroesophageal junction tumors: understanding the rising incidence of this disease. Semin Radiat Oncol 23:3–9. https://doi.org/10.1016/j.semradonc.2012.09.008
doi: 10.1016/j.semradonc.2012.09.008
pubmed: 23207041
pmcid: 3535292
Lagergren J, Lagergren P (2013) Recent developments in esophageal adenocarcinoma. CA Cancer J Clin 63:232–248. https://doi.org/10.1002/caac.21185
doi: 10.1002/caac.21185
pubmed: 23818335
Edgren G, Adami HO, Vainio EW, Nyrén O (2013) A global assessment of the oesophageal adenocarcinoma epidemic. Gut 62:1406–1414. https://doi.org/10.1136/gutjnl-2012-302412
doi: 10.1136/gutjnl-2012-302412
pubmed: 22917659
Sasako M, Sano T, Yamamoto S, Sairenji M, Arai K, Kinoshita T, Nashimoto A, Hiratsuka M (2006) Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol 7:644–651. https://doi.org/10.1016/S1470-2045(06)70766-5
doi: 10.1016/S1470-2045(06)70766-5
pubmed: 16887481
Kurokawa Y, Sasako M, Sano T, Yoshikawa T, Iwasaki Y, Nashimoto A, Ito S, Kurita A, Mizusawa J, Nakamura K (2015) Ten-year follow-up results of a randomized clinical trial comparing left thoracoabdominal and abdominal transhiatal approaches to total gastrectomy for adenocarcinoma of the oesophagogastric junction or gastric cardia. Br J Surg. https://doi.org/10.1002/bjs.9764
doi: 10.1002/bjs.9764
pubmed: 26506079
pmcid: 5024022
Kodera Y, Sano T (2017) Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 20:1–19. https://doi.org/10.1007/s10120-016-0622-4
doi: 10.1007/s10120-016-0622-4
Katai H, Mizusawa J, Katayama H, Takagi M, Yoshikawa T, Fukagawa T, Terashima M, Misawa K, Teshima S, Koeda K, Nunobe S, Fukushima N, Yasuda T, Asao Y, Fujiwara Y, Sasako M (2016) Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912. Gastric Cancer. https://doi.org/10.1007/s10120-016-0646-9
doi: 10.1007/s10120-016-0646-9
pubmed: 27722825
pmcid: 5321694
Inaki N, Etoh T, Ohyama T, Uchiyama K, Katada N, Koeda K, Yoshida K, Takagane A, Kojima K, Sakuramoto S, Shiraishi N, Kitano S (2015) A multi-institutional, prospective, phase II feasibility study of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer (JLSSG0901). World J Surg 39:2734–2741. https://doi.org/10.1007/s00268-015-3160-z
doi: 10.1007/s00268-015-3160-z
pubmed: 26170158
Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, Cho GS, Kim CY, Yang HK, Park DJ, Song KY, Il LS, Ryu SY, Lee JH, Lee HJ (2016) Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: Short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg 263:28–35. https://doi.org/10.1097/SLA.0000000000001346
doi: 10.1097/SLA.0000000000001346
pubmed: 26352529
Lee H-J, Hyung WJ, Yang H-K, Han SU, Park Y-K, An JY, Kim W, Kim H-I, Kim H-H, Ryu SW, Hur H, Kong S-H, Cho GS, Kim J-J, Park DJ, Ryu KW, Kim YW, Kim JW, Lee J-H, Kim M-C, Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group (2019) Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT). Ann Surg XX:1–9. https://doi.org/10.1097/SLA.0000000000003217
Kinoshita T, Uyama I, Terashima M, Noshiro H, Nagai E, Obama K, Tamamori Y, Nabae T, Honda M, Abe T, LOC-A Study Group (2018) Long-term outcomes of laparoscopic versus open surgery for clinical stage ii/iii gastric cancer: a multicenter cohort study in Japan (LOC-A Study). Ann Surg 264:214–222. https://doi.org/10.1097/SLA.0000000000002768
doi: 10.1097/SLA.0000000000002768
Hyung WJ, Yang HK, Han SU, Lee YJ, Park JM, Kim JJ, Kwon OK, Kong SH, Il KH, Lee HJ, Kim W, Ryu SW, Jin SH, Oh SJ, Ryu KW, Kim MC, Ahn HS, Park YK, Kim YH, Hwang SH, Kim JW, Cho GS (2019) A feasibility study of laparoscopic total gastrectomy for clinical stage I gastric cancer: a prospective multi-center phase II clinical trial, KLASS 03. Gastric Cancer 22:214–222. https://doi.org/10.1007/s10120-018-0864-4
doi: 10.1007/s10120-018-0864-4
pubmed: 30128720
Katai H, Mizusawa J, Katayama H, Kunisaki C, Sakuramoto S, Inaki N, Kinoshita T, Iwasaki Y, Misawa K, Takiguchi N, Kaji M, Okitsu H, Yoshikawa T, Terashima M (2019) Single-arm confirmatory trial of laparoscopy-assisted total or proximal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group study JCOG1401. Gastric Cancer. https://doi.org/10.1007/s10120-019-00929-9
doi: 10.1007/s10120-019-00929-9
pubmed: 31512081
Hosogi H, Yoshimura F, Yamaura T, Satoh S, Uyama I, Kanaya S (2014) Esophagogastric tube reconstruction with stapled pseudo-fornix in laparoscopic proximal gastrectomy: a novel technique proposed for Siewert type II tumors. Langenbeck’s Arch Surg 399:517–523. https://doi.org/10.1007/s00423-014-1163-0
doi: 10.1007/s00423-014-1163-0
Takiguchi S, Miyazaki Y, Shinno N, Makino T, Takahashi T, Kurokawa Y, Yamasaki M, Nakajima K, Miyata H, Mori M, Doki Y (2016) Laparoscopic mediastinal dissection via an open left diaphragm approach for advanced Siewert type II adenocarcinoma. Surg Today 46:129–134. https://doi.org/10.1007/s00595-015-1247-7
doi: 10.1007/s00595-015-1247-7
pubmed: 26374333
Kinoshita T, Gotohda N, Kato Y, Takahashi S, Konishi M, Okazumi S, Katoh R, Kinoshita T (2012) Laparoscopic transhiatal resection for siewert type II adenocarcinoma of the esophagogastric junction. Surg Laparosc Endosc Percutan Tech 22:e199–e203. https://doi.org/10.1097/SLE.0b013e31825a72e2
doi: 10.1097/SLE.0b013e31825a72e2
pubmed: 22874699
Sugita S, Kinoshita T, Kaito A, Watanabe M, Sunagawa H (2018) Short-term outcomes after laparoscopic versus open transhiatal resection of Siewert type II adenocarcinoma of the esophagogastric junction. Surg Endosc 32:383–390. https://doi.org/10.1007/s00464-017-5687-6
doi: 10.1007/s00464-017-5687-6
pubmed: 28656339
Huang C-M, Lv C-B, Lin J-X, Chen Q-Y, Zheng C-H, Li P, Xie J-W, Wang J-B, Lu J, Cao L-L, Lin M, Tu R-H (2016) Laparoscopic-assisted versus open total gastrectomy for Siewert type II and III esophagogastric junction carcinoma: a propensity score-matched case-control study. Surg Endosc. https://doi.org/10.1007/s00464-016-5375-y
doi: 10.1007/s00464-016-5375-y
pubmed: 28008469
pmcid: 5112298
Zhao Y, Zhang J, Yang D, Tang Z, Wang Q (2019) Feasibility of laparoscopic total gastrectomy for advanced Siewert type II and type III esophagogastric junction carcinoma: a propensity score-matched case-control study. Asian J Surg. https://doi.org/10.1016/j.asjsur.2018.12.014
doi: 10.1016/j.asjsur.2018.12.014
pubmed: 31611103
Shi Y, Li L, Xiao H, Guo S, Wang G, Tao K, Dong J, Zong L (2018) Feasibility of laparoscopic gastrectomy for patients with Siewert-type II/III adenocarcinoma of the esophagogastric junction: a propensity score matching analysis. PLoS ONE 13:1–10. https://doi.org/10.1371/journal.pone.0203125
doi: 10.1371/journal.pone.0203125
Sobin L, Gospodarowicz MWC (2009) TNM classification of malignant tumours, 7th edn. Wiley, New York
Sano T, Kodera Y (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–112. https://doi.org/10.1007/s10120-011-0041-5
doi: 10.1007/s10120-011-0041-5
Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
doi: 10.1097/01.sla.0000133083.54934.ae
pubmed: 15273542
pmcid: 1360123
Kurokawa Y, Takeuchi H, Doki Y, Mine S, Terashima M, Yasuda T, Yoshida K, Daiko H, Sakuramoto S, Yoshikawa T, Kunisaki C, Seto Y, Tamura S, Shimokawa T, Sano T, Kitagawa Y (2019) Mapping of lymph node metastasis from esophagogastric junction tumors A prospective nationwide multicenter study. Ann Surg. https://doi.org/10.1097/SLA.0000000000003499
doi: 10.1097/SLA.0000000000003499
pubmed: 31425284
Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, Nashimoto A, Fujii M, Nakajima T, Ohashi Y (2011) Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol 29:4387–4393. https://doi.org/10.1200/JCO.2011.36.5908
doi: 10.1200/JCO.2011.36.5908
pubmed: 22010012
Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, Lee KW, Kim YH, Noh SI, Cho JY, Mok YJ, Kim YH, Ji J, Sen YT, Button P, Sirzén F, Noh SH (2012) Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet 379:315–321. https://doi.org/10.1016/S0140-6736(11)61873-4
doi: 10.1016/S0140-6736(11)61873-4
pubmed: 22226517
Kaito A, Kinoshita T, Shitara K, Shibasaki H, Nishida T (2017) Timing of initiation of adjuvant chemotherapy for gastric cancer: a case-matched comparison study of laparoscopic vs. open surgery. Eur J Surg Oncol 43:801–807. https://doi.org/10.1016/j.ejso.2017.01.008
doi: 10.1016/j.ejso.2017.01.008
pubmed: 28187877
Fujitani K, Kurokawa Y, Takeno A, Endoh S, Ohmori T, Fujita J, Yamasaki M, Takiguchi S, Mori M, Doki Y (2018) Time to initiation or duration of S-1 adjuvant chemotherapy; which really impacts on survival in stage II and III gastric cancer? Gastric Cancer 21:446–452. https://doi.org/10.1007/s10120-017-0767-9
doi: 10.1007/s10120-017-0767-9
pubmed: 28965205
Nakanishi K, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, Murai T, Asada T, Ishiyama A, Matsushita H, Tanaka C, Kobayashi D, Fujiwara M, Murotani K, Kodera Y (2019) Delay in initiation of postoperative adjuvant chemotherapy with S-1 monotherapy and prognosis for gastric cancer patients: analysis of a multi-institutional dataset. Gastric Cancer. https://doi.org/10.1007/s10120-019-00961-9
doi: 10.1007/s10120-019-00961-9
pubmed: 31055693