Proximal Versus Total Gastrectomy for Locally Advanced Siewert Type II-III Gastroesophageal Junction Cancer

Summary

This multicenter prospective randomized clinical trial aims to compare the safety and oncological effectiveness of proximal gastrectomy and total gastrectomy in patients with locally advanced Siewert type II-III gastroesophageal junction cancer. Eligible patients will be randomly assigned to undergo either proximal gastrectomy or total gastrectomy using open, laparoscopic, or robotic surgical approaches according to clinical suitability. The primary outcome of the study is 3-year disease-free survival. Secondary outcomes include postoperative mortality, postoperative complications, and the number of metastatic lymph nodes retrieved. Patients will be followed for up to five years after surgery to evaluate long-term oncological outcomes.

Eligibility

Inclusion Criteria:

* Age between 18 and 90 years
* Histologically confirmed locally advanced Siewert type II-III gastroesophageal junction cancer
* Considered operable after multidisciplinary tumor board evaluation
* Candidate for curative surgical resection with D2 lymphadenectomy
* Provision of written informed consent

Exclusion Criteria:

* Early-stage gastroesophageal junction cancer
* Gastric cancers located in the antrum or corpus
* Severe anesthetic risk (American Society of Anesthesiologists \[ASA\] class IV or higher)
* Pregnancy
* Patients unwilling or unable to provide informed consent

Conditions4

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