Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy

Thibault Voron; Caroline Gronnier; Arnaud Pasquer; Jeremie Thereaux; Johan Gagniere; Gil Lebreton; Bernard Meunier; Denis Collet; Guillaume Piessen; François Paye; Jean Pierre Arnaud; Jean Michel Balon; Frank Bonnetain; Frederic Borie; Dorothée Brachet; Cécile Brigand; Nicolas Carrere; Xavier Benoit D'Journo; Pierre Dechelotte; Jean Robert Delpero; Abdenaceur Dhari; Sylvain Fabre; Manuel Fernandez; Renaud Flamein; Brigitte Gillet; Aude Glaise; Olivier Glehen; Diane Goéré; Marie Guilbert; Jérôme Guiramand; Mohamed Hebbar; Noël Huten; Emmanuelle Leteurtre; Kevin Kraft; Damien Louis; Jean Yves Mabrut; Benjamin Mathieu; Sophie Michalak; Francis Michot; Bertrand Millat; Jeremie H. Lefevre; Fédérique Peschaud; Denis Pezet; Virginie Pichot-Delahaye; Marc Pocard; Ariane Poisson; Michel Prudhomme; Jean Marc Regimbeau; Timothée Thiébot; Pascal- Alexandre Thomas; Basile Tsilividis; Florence Vandois; FREGAT working group - FRENCH

doi:10.1016/j.ejso.2019.07.022

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Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy

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Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy

Thibault Voron, Caroline Gronnier, Arnaud Pasquer, Jeremie Thereaux, Johan Gagniere, Gil Lebreton, Bernard Meunier, Denis Collet, Guillaume Piessen, François Paye, …

European journal of surgical oncology, Vol.45(12), pp.2473-2481

01/12/2019

DOI: https://doi.org/10.1016/j.ejso.2019.07.022

PMID: 31350076

Résumé

Oesophago-gastric junction

Siewert classification

Superior polar oesogastrectomy

Total gastrectomy

True cardia adenocarcinoma

Type II AEG is now considered as oesophageal cancer in the seventh and eighth edition of TNM classification but optimal surgical approach for these tumors remains debated. The objective of the study is to assess and compare surgical and oncological outcomes of two surgical approaches: superior polar oesogastrectomy (SPO) or total gastrectomy (TG) in patients with type II adenocarcinoma of the oesophagogastric junction (AEG). 183 patients with type II AEG treated from 1997 to 2010 in 21 French centers by SPO or TG were included in a multicenter retrospective study. The surgical and oncological outcomes were compared between these two surgical approaches. A TG was performed in 64 (35%) patients whereas 119 (65%) patients were treated by SPO with transthoracic approach in 100 of them (83.2%) and transhiatal approach with cervicotomy in 19 (16.8%). Surgical outcomes were comparable between the two approaches with a postoperative mortality rate of 4.9% and a severe operative morbidity rate within 30 days of 15.3%. Median survival in patients operated on by TG was of 46 months compared to 27 months in patients treated by SPO (p = 0.118). At multivariate analysis, TG appears to be an independent good prognostic factor compared to SPO (HR = 1.847; p = 0.008). However, TG was also associated with a higher rate of incomplete resection, (12.5% vs 5.9%; p = 0.120). When TG allows obtaining tumor-free resection margins, this approach should be preferred to SPO.

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Titre: Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy
Créateurs - sans rôle: Thibault Voron - Sorbonne Université, Department of Digestive Surgery, Saint Antoine Hospital, AP-HP, 75012, Paris, France
Caroline Gronnier - Department of Digestive Surgery, Haut-Lévêque University Hospital, Bordeaux, France
Arnaud Pasquer - Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France
Jeremie Thereaux - Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France
Johan Gagniere - Estaing University Hospital, Clermont-Ferrand, France
Gil Lebreton - Côte de Nacre University Hospital, Caen, France
Bernard Meunier - Department of Digestive and Hepatobiliary Surgery, Pontchaillou University Hospital, Rennes, France
Denis Collet - Department of Digestive Surgery, Haut-Lévêque University Hospital, Bordeaux, France
Guillaume Piessen - Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
François Paye - Assistance Publique – Hôpitaux de Paris
Jean Pierre Arnaud - Department of Digestive Surgery, Angers University Hospital, Angers, France
Jean Michel Balon - Department of Digestive Surgery, Clinique Jules Verne, Nantes, France
Frank Bonnetain - Unit of Biostatistic and Epidemiological of Dijon Georges Francois Leclerc Center, Dijon, France
Frederic Borie - Department of Digestive Surgery, Nîmes University Hospital, Nimes, France
Dorothée Brachet - Department of Digestive Surgery, Angers University Hospital, Angers, France
Cécile Brigand - Hôpitaux Universitaires de Strasbourg
Nicolas Carrere - Department of Digestive Surgery, Toulouse University Hospital, Toulouse, France
Xavier Benoit D'Journo - Department of Digestive Surgery, Nord University Hospital, Marseille, France
Pierre Dechelotte - Department of Pathology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Jean Robert Delpero - Department of Digestive Surgery, Paoli Calmette Institute, Marseille, France
Abdenaceur Dhari - Department of Digestive Surgery, Amiens University Hospital, Amiens, France
Sylvain Fabre - Department of Digestive Surgery, Clinique Jules Verne, Nantes, France
Manuel Fernandez - Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
Renaud Flamein - Department of Digestive Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Brigitte Gillet - Department of Digestive Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Aude Glaise - Department of Digestive Surgery, Montpellier University Hospital, Montpellier, France
Olivier Glehen - Department of Digestive Surgery, Lyon Sud University Hospital, Lyon, France
Diane Goéré - Department of Digestive Surgery, Gustave Roussy Institute, Villejuif, France
Marie Guilbert - Department of Digestive Surgery, Lille University Hospital, Lille, France
Jérôme Guiramand - Department of Digestive Surgery, Paoli Calmette Institute, Marseille, France
Mohamed Hebbar - Department of Medical Oncology, Lille University Hospital, Lille, France
Noël Huten - Department of Digestive Surgery, Tours University Hospital, Tours, France
Emmanuelle Leteurtre - Department of Pathology, Lille University Hospital, Lille, France
Kevin Kraft - Department of Digestive Surgery, Tours University Hospital, Tours, France
Damien Louis - Department of Digestive Surgery, Toulouse University Hospital, Toulouse, France
Jean Yves Mabrut - Department of Digestive Surgery, Lyon University Hospital, Lyon, France
Benjamin Mathieu - Department of Digestive Surgery, Montpellier University Hospital, Montpellier, France
Sophie Michalak - Department of Pathology, Angers University Hospital, Angers, France
Francis Michot - Department of Digestive Surgery, Rouen University Hospital, Rouen, France
Bertrand Millat - Department of Digestive Surgery, Montpellier University Hospital, Montpellier, France
Jeremie H. Lefevre - Department of Digestive Surgery, St Antoine University Hospital, Paris, France
Fédérique Peschaud - Department of Digestive Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France
Denis Pezet - Department of Digestive Surgery, Montpellier University Hospital, Montpellier, France
Virginie Pichot-Delahaye - Department of Digestive Surgery, Lyon University Hospital, Lyon, France
Marc Pocard - Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
Ariane Poisson - Department of Digestive Surgery, Lille University Hospital, Lille, France
Michel Prudhomme - Department of Digestive Surgery, Nîmes University Hospital, Nimes, France
Jean Marc Regimbeau - Department of Digestive Surgery, Amiens University Hospital, Amiens, France
Timothée Thiébot - Department of Digestive Surgery, Rennes University Hospital, Rennes, France
Pascal- Alexandre Thomas - Department of Digestive Surgery Nord University Hospital, Marseille, France
Basile Tsilividis - Department of Digestive Surgery, Rouen University Hospital, Rouen, France
Florence Vandois - Department of Digestive Surgery, Lille University Hospital, Lille, France
FREGAT working group - FRENCH
Détails de publication: European journal of surgical oncology, Vol.45(12), pp.2473-2481
Éditeur: Elsevier Ltd
Nombre de pages: 9
Identifiants: 99150212909311
Unité académique: Initial MAnagement & prevent of acute orGan failures IN critically ill patiEnts - IMAGINE; Institut Desbrest d Epidemiologie et de Sante Publique - IDESP
Langue: English
Type de ressource: Journal article