title: Feasibility and Safety of Transhiatal Approach and D2 Total Gastrectomy after Neoadjuvant Chemotherapy for Adenocarcinoma of the Esophago-Gastric Junction: A Subset Analysis of the COMPASS Trial.
abstract: BACKGROUND
  It was unclear whether the transhiatal approach and D2 total gastrectomy after neoadjuvant chemotherapy (NAC) for adenocarcinoma of the esophago-gastric (AEG) junction are as feasible and safe as D2 gastrectomy following NAC.
  
  
  METHODS
  We clarified the short-term surgical results in AEG and non-AEG patients in a subset analysis of the COMPASS trial.
  
  
  RESULTS
  Eighty-three patients, 24 with AEG and 59 with non-AEG, were registered in the study. Among 24 patients with AEG, 5 were classified to have Siewert type I, 11 to have type II and 8 to have type III. The tumor progression, completion of NAC, and clinical and pathological responses were similar between the groups. Twenty-four AEG and 51 non-AEG patients proceeded to surgery. The extent of dissection (D1/D2) was 3/21 in the AEG and 3/48 in the non-AEG patients. The R0 resection rate was 69% in the non-AEG and 88% in the AEG patients. Neither grade 3b/4 morbidity nor surgical mortality was observed in either group.
  
  
  CONCLUSIONS
  The transhiatal approach and D2 total gastrectomy after NAC seem to be as safe and feasible as D2 gastrectomy for non-AEG cancer.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hayashi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Cho
authors.forename: Yumi
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuburaya
authors.forename: Junichi
authors.initials: J
authors.lastname: Sakamoto
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004210:Dissection; D004338:Drug Combinations; D004943:Esophagogastric Junction / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel; D002945:Cisplatin