Masazumi Sakaguchi, MD, PhD, Norihiro Shimoike, MD, Shin Akagawa, MD, PhD, Seiichiro Kanaya, MD, PhD. Osaka Red Cross Hospital
Background: There is a lack of clarity on the optimal surgical procedure for Siewert type II esophagogastric junction cancer (type II EGJ cancer). We proposed laparoscopic proximal gastrectomy (LPG) with esophagogastric tube reconstruction as the treatment of choice for early-stage type II EGJ cancer and/or for high-risk patients who required tumor resection. In the present study, we evaluated the short-term outcomes of patients with type II EGJ cancer undergoing LPG.
Method: We performed a retrospective descriptive study of patients with type II EGJ cancer who underwent LPG at our hospital between April 2011 and April 2018.
Results: We identified 29 consecutive patients with type II EGJ cancer who were planned to undergo LPG with transhiatal lower paraesophageal lymphadenectomy. The median follow-up was 591 days (interquartile range, IQR: 1042–329). The median age was 75 years (IQR: 80–68). The number of patients with ASA-PS 2 or 3 was 21 (72.4%). The number of patients with ECOG-PS 2 or 3 was 14 (48.1%). The clinical stage (AJCC 7th) was IA:IB:IIA:IIB:IIIA:IIIB:IIIC:IV = 9:4:1:2:4:1:7:1. All tumors were found to be an adenocarcinoma. Only 3 patients received neoadjuvant chemotherapy. Twenty-eight patients underwent LPG with perigastric, suprapancreatic, and transhiatal lower paraesophageal lymphadenectomy, and one patient converted to transthoracic esophagectomy to guarantee safety of the proximal margin. The Clavian−Dindo classification grade 2 and higher complication rate was 48.3%. The median postoperative stay was 16 days (IQR: 30–13). The pathological stage was IA:IB:IIA:IIB:IIIA:IIIB:IIIC:IV = 6:4:4:1:3:2:5:4. The 1-year overall survival rate was found to be 72.4%.
Conclusion: LPG can be a successful treatment for elderly patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94350
Program Number: P619
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster