Abstract 473P
Background
There is an ongoing debate regarding the ideal surgical strategy for locally advanced Siewert II/III AEG, and limited research examines the survival outcomes of locally advanced Siewert II/III AEG patients treated with proximal gas-trectomy (PG) in comparison to those undergoing total gastrectomy (TG). This study aimed to compare the outcomes of TG and PG in locally advanced Siewert II/III esophagogastric junction cancer, focusing on surgical outcomes such as postoperative complications and long-term survival.
Methods
Data from 171 patients who underwent gastrectomy for Siewert type II/III AEG between 2004 and 2020 were assessed. The clinicopathological characteristics and prognostic outcomes between TG and PG groups were compared. Inverse probability of treatment weighting (IPTW) and multivariate Cox regression analysis were conducted to account for covariate effects and identify factors associated with overall survival (OS).
Results
The TG group had a greater percentage of advanced-stage disease, number of retrieved lymph nodes and proportion of transthoracic resection compared to the PG group. In regard to postoperative complications, the rates were similar between PG (26.6%) and TG (20.8%) groups (P = 0.918). The 5-year OS rates were 49.2% for the PG group and 38.8% for the TG group, respectively (P = 0.171). Multivariate analysis and IPTW indicated that age, tumor grade, total number of LNs removed, pT stage, pN stage, and resection margin status were the independent factors for OS and the type of resection did not significantly impact OS.
Conclusions
The results showed comparable rates of surgical complications between PG and TG. Importantly, TG did not demonstrate superior survival outcomes compared to PG for locally advanced Siewert type II or III AEG. Thus, PG can be considered a reasonable choice for patients with locally advanced Siewert type II or III AEG.
Legal entity responsible for the study
Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.