Surgical Option for Sufficient Safety Margine in Locally Advanced Type II Cardia Cancer-Left Colon Interposition

2008 ◽  
Vol 8 (2) ◽  
pp. 97
Author(s):  
Ho Young Yoon ◽  
Hyoung Il Kim ◽  
Sang Hoon Lee ◽  
Choong Bai Kim
Keyword(s):  
Locally Advanced ◽  
Left Colon ◽  
Colon Interposition ◽  
Type Ii ◽  
Cardia Cancer ◽  
Surgical Option

scholarly journals Proximal Gastrectomy versus Total Gastrectomy for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Comprehensive Analysis of Data from the SEER Registry

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Kaixuan Zhu ◽  
Yingying Xu ◽  
Jiaxin Fu ◽  
Farah Abdidahir Mohamud ◽  
Zongkui Duan ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Surgical Approach ◽  
Esophagogastric Junction ◽  
Proximal Gastrectomy ◽  
Locally Advanced ◽  
Cox Proportional Hazards Model ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii ◽  
Significant Difference

Background. To determine the ideal surgical approach (total gastrectomy (TG) vs. proximal gastrectomy (PG)) for Siewert type II adenocarcinoma of the esophagogastric junction (AEG), we searched and analyzed the Surveillance, Epidemiology, and End Results (SEER) data. Methods. Patients with Siewert type II AEG treated by TG or PG were identified from the 2004–2014 SEER dataset. We obtained the patients’ overall survival (OS) and cancer-specific survival (CSS) and stratified the patients by surgical approach. We performed a propensity score 1 : 1 matching (PSM) analysis and a univariate and multivariate Cox proportional hazards model. Results. A total of 2,217 patients with 6th AJCC stage IA–IIIB Siewert type II AEG was examined: 1,584 patients (71.4%) underwent PG, and 633 patients (28.6%) underwent TG. The follow-up time was 1–131 months. OS favored total gastrectomy before the PSM analysis (χ2=3.952, p=0.047), but after this analysis, there was no significant difference between TG and PG (χ2=2.227, p=0.136). The univariate and multivariate analyses identified age as an independent factor, and an X-tail analysis revealed 70 years as a cut-off point. The patients aged≥70 years obtained a significant long-term OS benefit from PG compared to TG (χ2=8.245, p=0.004), and those aged<70 years showed no difference between TG and PG (χ2=0.167, p=0.682). Conclusions. PG showed an equivalent survival benefit to TG in both the early and locally advanced stages of Siewert type II AEG. For elderly patients, PG is strongly recommended because of its clearer OS benefit compared to TG.

Transhiatal distal esophagectomy for Siewert type II cardia cancer can be a treatment option in selected patients

2019 ◽  
Vol 45 (10) ◽  
pp. 1943-1949 ◽  
Author(s):  
Rossella Reddavid ◽  
Paolo Strignano ◽  
Silvia Sofia ◽  
Andrea Evangelista ◽  
Giacomo Deiro ◽  
...  
Keyword(s):  
Treatment Option ◽  
Type Ii ◽  
Cardia Cancer ◽  
Siewert Type ◽  
Siewert Type Ii

Pattern of regional recurrence after curative resection in locally advanced adenocarcinoma of gastroesophageal junction: Implication for elective lymphatic target delineation of radiotherapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 158-158
Author(s):  
Jiajia Zhang ◽  
Jing Jin ◽  
Wang Xin
Keyword(s):  
Curative Resection ◽  
Locally Advanced ◽  
Target Volume ◽  
Ct Images ◽  
Regional Recurrence ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii ◽  
Regional Failure

158 Background: To investigated the regional recurrence pattern of Siewert type II/III AGE patients after curative resection and refine the clinical target volume (CTV) delineation of radiotherapy. Methods: From 2009 to 2013, 78 patients who were histopathologically diagnosed with locally advanced AGE (T3/4 or any N+, Siewert II/III) after curative resection and confirmed of regional recurrence in follow-up CT images were retrospectively reviewed. First regional recurrence was recorded and one diagnostic radiologist with specialty of gastrointestinal tract investigated. Pattern of regional failure at each node station were analyzed. Reference CT images were obtained from a healthy volunteer. We then delineated the epicenters of recurrence sites at the equivalent location, based on the same vessels of reference CT images compared with the recurrence CT images on Pinnacle planning system. The combined contour of all recurrence sites was presented on a digitally reconstructed radiograph (DRR) image. Results: Most recurrence occurred within 2 years of follow-up (Median, 10.9 m). Of all, 35 (44.9%) patients had regional failure (RF) only; 24 (38%) had RF simultaneous with distant failure; 11 (14.1%) were locoregional, and 8 (10.3%) had concurrent distant and locoreginal failure. The most common recurrent node stations were No.16 (62.8%), No. 9 (32.1%), No. 11 (24.4%), No. 8 (17.9%), No. 7 (16.7%), No. 112 (12.8%), No. 4 (12.8%) and No. 12 (10.3%), respectively. 11 patients (14.1%) had recurrence at mediastinal lymph nodes. There was no significant difference of NF between Siewert type II and III AEG except for No. 9 (42.2% vs 18.2%, P = 0.027). The frequency and location of RF was shown by CT and digitally reconstructed radiograph (DRR) images. A three-dimensional (3D) atlas based on vessel delineation and distribution of RF was established. Conclusions: The most prevalent regional recurrence in Siewert type II/III AEG patients after curative resection was along the abdominal aorta, celiac artery and splenic artery. Our findings suggest a modified elective lymphatic target volume for IMRT contours in those patients.

scholarly journals Safety and feasibility of single‑port laparoscopic multivisceral resection for locally advanced left colon cancer

2018 ◽  
Author(s):  
Mitsuyoshi Tei ◽  
Masahisa Otsuka ◽  
Yozo Suzuki ◽  
Kentaro Kishi ◽  
Masahiro Tanemura ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Single Port ◽  
Locally Advanced ◽  
Multivisceral Resection ◽  
Left Colon ◽  
Left Colon Cancer

scholarly journals Short-Term Clinical Efficacy of Neoadjuvant Chemotherapy Combined With Laparoscopic Gastrectomy for Locally Advanced Siewert Type II and III Adenocarcinoma of the Esophagogastric Junction: A Retrospective, Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qing Feng ◽  
Du Long ◽  
Ming-shan Du ◽  
Xiao-song Wang ◽  
Zhen-shun Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Esophagogastric Junction ◽  
Independent Risk Factor ◽  
Locally Advanced ◽  
Type Ii ◽  
Short Term ◽  
Siewert Type ◽  
Siewert Type Ii

BackgroundLaparoscopic gastrectomy (LG) has been increasingly used for the treatment of locally advanced Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). However, whether LG can achieve the same short-term efficacy in the treatment of patients who receive neoadjuvant chemotherapy (NACT) remains controversial. Thus, the aim of this study was to investigate the clinical outcomes of NACT combined with LG for Siewert type II and III AEG.MethodsThis retrospective study identified patients with locally advanced Siewert type II and III AEG diagnosed between May 2011 and October 2020 using the clinical tumor-node-metastasis (cTNM) staging system. The short-term outcomes were compared between the matched groups using a 1:3 propensity score matching (PSM) method, which was performed to reduce bias in patient selection.ResultsAfter PSM, 164 patients were selected, including 41 in the NACT group and 123 in the LG group. The baseline characteristics were similar between the two groups. Compared with the LG group, the NACT group exhibit a smaller tumor size and significantly less advanced pathological tumor classification and nodal classification stages. The time to first flatus of the NACT group was significantly shorter, but the hospital stay was significantly longer than that of the LG group. The NACT group showed similar overall (29.3% vs 25.2%, P=0.683), systemic (24.4% vs 21.1%, P=0.663), local (12.2% vs 9.8%, P=0.767), minor (19.5% vs 19.5%, P=1.000) and major (9.8% vs 5.7%, P=0.470) complications as the LG group. Subgroup analyses showed no significant differences in most stratified parameters. Operation time≥ 300 minutes was identified as an independent risk factor for overall complications. Age≥ 60 years was identified as an independent risk factor for major complications.ConclusionNACT combined with LG for AEG does not increase the risk of postoperative morbidity and mortality compared with LG.

743 SIEWERT TYPE II GASTRIC CARDIA CANCER: ANALYSIS OF THE RESULTS OF DIFFERENT SURGICAL OPTIONS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Ana Navío-Seller ◽  
David Abelló-Audí ◽  
Mireia Navasquillo-Tamarit ◽  
Milton Emmanuel De Jesús-Acosta ◽  
Marcos Bruna-Esteban ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Locally Advanced ◽  
Surgical Techniques ◽  
Disease Free Survival ◽  
Gastric Cardia ◽  
Distal Margin ◽  
Gastric Cardia Adenocarcinoma ◽  
Type Ii ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy

Abstract   The management of gastric cardia tumors should be carried out from a multidisciplinary approach, there is currently a clear controversy regarding the most appropriate surgical approach to use in type II tumors. Depending on their topographic anatomical characteristics based on the degree of gastric invasion and esophageal, the surgical technique may change: esophagectomy, gastrectomy with distal esophagectomy, or total esophageal gastrectomy. Methods Retrospective and analytical study of patients diagnosed with type II gastric cardia adenocarcinoma (based on the results of the pathological study of the resection specimen) who underwent surgical treatment in our center from June 2012 to June 2020. Different preoperative parameters, the surgical techniques used and the results obtained were analyzed. Results 25 patients were studied, 84% male. 60% were locally advanced tumors with 56% affected nodes. 12 Ivor-Lewis esophagectomies, 5 esophagogastrectomies with coloplasty, and 5 extended total gastrectomies were performed. There was no resection proximal or distal margin involvement, but circumferential margin was affected in 60% of cases of extended gastrectomy and in 1 case of Ivor-Lewis esophagectomy. Median number of lymph nodes removed was 22(5–37) and 2(0–12) affected, being higher in total esophagogastrectomy. Postoperative morbidity was 40% and 90-day mortality 4% (1 case). The mean follow-up was 37 months, noting recurrence in 9 cases (36%), with disease-free survival of 44%. Conclusion The surgical treatment approach in type II gastric tumors is controversial, and there are multiple options to consider. According to the results of this study, the Ivor-Lewis esophagectomy shows to be a safe approach with satisfactory oncological results in tumors that do not require a total esophagogastrectomy.

Sign in / Sign up

Export Citation Format

Share Document