title: Long-term outcomes of extended proximal gastrectomy for oesophagogastric junctional tumours.
abstract: BACKGROUND
  There is no consensus on the optimum approach for resection of oesophagogastric junctional (OGJ) tumours. We prospectively evaluated the efficacy of transabdominal radical extended proximal gastrectomy with oesophagogastric anastomosis (EPGOG) for selected tumours of the OGJ.
  
  
  METHODS
  Between 1998 and 2007, 66 selected consecutive patients with tumours of the OGJ underwent successful EPGOG. Selection was limited to tumours where the maximal proximal extent was 36 cm ab oral. Pre-, peri-, and postoperative outcomes together with long-term survival data for these patients were prospectively collected.
  
  
  RESULTS
  Median theatre time was 242 min (range = 120-480), with a median blood loss of 300 ml (range = 50-1720). Eighty-nine percent of patients were extubated in theatre; major complications occurred in 9 (14%) patients, with an overall in-hospital mortality rate of 8%. Thirty-five (53%) patients had nodal disease and the median lymph node yield was 13 (range = 4-36), with an R0 resection rate of 80%. In terms of long-term outcomes, the 2- and 5-year actuarial survival rates were 54 ± 6% and 41 ± 6%.
  
  
  CONCLUSIONS
  Extended radical proximal gastrectomy with oesophagogastric anastomosis for selected junctional tumours is a feasible technique which does not compromise oncological principles as evidenced by an excellent long-term survival rate.
authors.affiliation: Department of Upper GI Surgery, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK. omarkhan@iname.com
authors.forename: Omar
authors.initials: O
authors.lastname: Khan
authors.forename: Steven
authors.initials: S
authors.lastname: Goh
authors.forename: Ben
authors.initials: B
authors.lastname: Byrne
authors.forename: Shaw
authors.initials: S
authors.lastname: Somers
authors.forename: Stuart
authors.initials: S
authors.lastname: Mercer
authors.forename: Simon
authors.initials: S
authors.lastname: Toh
mesh_terms: D004943:Esophagogastric Junction; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome