Adenocarcinoma of the Esophagogastric Junction, Gastric Adenocarcinoma
Conditions
Keywords
Proximal gastrectomy, Double-tract reconstruction, Reflux esophagitis, Postoperative nutrition
Brief summary
This two-center retrospective observational cohort study compares Chinese and Russian patients who underwent curative proximal gastrectomy with double-tract reconstruction for proximal gastric adenocarcinoma or Siewert type II/III adenocarcinoma of the esophagogastric junction. The study evaluates postoperative reflux, nutritional status, perioperative outcomes, complications, and long-term survival. Propensity score matching will be used to improve comparability between the two cohorts.
Interventions
PROCEDUREProximal gastrectomy with double-tract reconstruction
Curative proximal gastrectomy followed by double-tract reconstruction performed as part of routine clinical care. The study does not assign treatment and retrospectively analyzes existing clinical data.
Sponsors
The First Affiliated Hospital with Nanjing Medical University
Moscow Clinical Scientific Center named after A.S. Loginov
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18 to 75 years. 2. Histologically confirmed gastric adenocarcinoma or Siewert type II/III adenocarcinoma of the esophagogastric junction. 3. Underwent proximal gastrectomy with double-tract reconstruction. 4. Surgery performed with curative intent. 5. At least one valid postoperative follow-up record containing reflux, nutritional, or complication information. 6. Clinical, pathological, operative, and follow-up data sufficiently complete for analysis, with less than 20 percent missingness in key variables.
Exclusion criteria
1. Previous gastric or esophageal surgery, except limited endoscopic treatment such as endoscopic mucosal resection. 2. Synchronous or metachronous malignancy, except cured non-melanoma skin cancer or cervical carcinoma in situ. 3. Complete absence of follow-up data. 4. Double-tract reconstruction not completed or changed to another reconstruction method. 5. Severe preoperative reflux disease, defined as GERD-Q score greater than 8 with a requirement for long-term medication.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in serum albumin | From preoperative baseline to 1 year after surgery | Change in serum albumin concentration, measured in grams per liter. |
| Change in hemoglobin | From preoperative baseline to 1 year after surgery | Change in hemoglobin concentration, measured in grams per liter. |
| Endoscopic reflux esophagitis | 1 year after surgery | Presence and severity of reflux esophagitis assessed by endoscopy using the Los Angeles classification (grades A-D). |
| Clinically significant reflux symptoms | 1 year after surgery | Reflux symptoms assessed using the GERD-Q questionnaire; a total score greater than 8 is considered clinically significant reflux. |
| Change in body mass index | From preoperative baseline to 1 year after surgery | Change in body mass index, measured in kilograms per square meter. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative complications | Within 30 days after surgery | Overall complications, severe complications defined as Clavien-Dindo grade IIIa or higher, anastomotic leakage, and anastomotic stricture requiring endoscopic dilation or another intervention. |
| Disease-free survival | From the date of surgery until recurrence, death, or last follow-up, up to 12 years | Time from surgery to first local, regional, or distant recurrence or death from any cause. Event-free participants will be censored at last follow-up. |
| Overall survival | From the date of surgery until death or last follow-up, up to 12 years | Time from surgery to death from any cause. Participants alive at last follow-up will be censored. |
| intraoperative blood loss | from surgery to discharge, up to 6 months | intraoperative blood loss in milliliters |
| postoperative length of hospital stay | from surgery to discharge, up to 6 months. | postoperative length of hospital stay in days |
| conversion to open surgery | from surgery to discharge, up to 6 months | conversion to open surgery among patients undergoing minimally invasive surgery (percentage). |
| Perioperative outcomes-Operative time | From surgery through hospital discharge, up to 6 months | Operative time in minutes |
Countries
China, Russia
Contacts
CONTACTHao Xu
PRINCIPAL_INVESTIGATORHao Xu
The First Affiliated Hospital with Nanjing Medical University
PRINCIPAL_INVESTIGATORRoman Izrailov
Moscow Clinical Scientific Center named after A.S. Loginov
Outcome results
None listed