Comparison of quality of life in patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction treated by three different operations_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Yu , SHI Guidong , TIAN Dong , NING Dong , CHENG Liang , LIU Junhong ,  FU Maoyong

Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 629000, Sichuan, P.R.China;

Corresponding author：

FU Maoyong, Email: fumaoyongdm@163.com

Keywords：

Esophagogastric junction; adenocarcinoma; Siewert type Ⅱ; operations; quality of life

DOI：

10.7507/1007-4848.201902021

Video：

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Objective To compare the quality of life (QOL) of advanced Siewert type Ⅱ adenocarcinoma esophagogastric junction (AEG) patients treated by the total gastrectomy, traditional proximal gastrectomy or proximal gastrectomy with gastric tube reconstruction opertations, and to provide some clinical basis for the choice of surgical methods for AEG. Methods A total of 90 patients with Siewert type Ⅱ AEG were retrospectively collected from the Affiliated Hospital of North Sichuan Medical College. Patients were divided into 3 groups according to different surgical methods (n=30 in each group), a total gastrectomy group (23 males, 7 females, aged 47-79 years), a traditional proximal gastrectomy group (treated with the traditional proximal gastrectomy procedure, 19 males, 11 females, aged 44-80 years), and a narrow gastric tube group (treated with the proximal gastrectomy with gastric tube reconstruction procedure, 25 males, 5 females, aged 47-83 years). The Chinese version of Quality of Life Questionnaire Core-30 (QLQ-C30) and Quality of Life Questionnaire Oesophagogastric-25 (QLQ-OG25) designed by European Organization for Research and Treatment of Cancer (EORTC) were used to collect the patients’ information in the three groups about their QOL during the first six months and one year after the three procedures. Results There was no statistical difference in the clinical data among the three groups (all P>0.05). QOL during the first six months after the operations assessed by the QLQ-C30 questionnaire table showed that the narrow gastric tube group was significantly best in total QOL, physical function, fatigue, and emotional function among the three groups (all P<0.05). The total gastrectomy group was the worst in role function, dyspnea, fatigue and diarrhea among the three groups (all P<0.05). The traditional proximal gastrectomy group had a worse evaluation in lose of appetite than the other two groups (P<0.05). QOL during the first six months after the operations assessed by the QLQ-OG25 questionnaire table showed that the traditional proximal gastrectomy group had a significantly worse evaluation in palirrhea than the other two groups (both P<0.05). The total gastrectomy group had a significantly worse evaluation in anxiety than the other two groups (both P<0.05). QOL during the first year after the operations assessed by the QLQ-C30 questionnaire table showed that the narrow gastric tube group had a significantly highest evaluation in total QOL physical function and emotional function among the three groups (all P<0.05). The total gastrectomy group had a significantly worst evaluation in diarrhea among the three groups (P<0.05). QOL during the first year after operations assessed by QLQ-OG25 questionnaire table showed that the traditional proximal gastrectomy group had a significantly worse evaluation in palirrhea than the other two groups (all P<0.05). Conclusion The narrow tubular esophagogastric anastomosis is better than the total gastrectomy and the traditional proximal gastrectomy for the treatment of the advanced Siewert type Ⅱ adenocarcinoma of esophagogastric junction, so this operation is worth being recommended.

Citation： ZHOU Yu, SHI Guidong, TIAN Dong, NING Dong, CHENG Liang, LIU Junhong, FU Maoyong. Comparison of quality of life in patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction treated by three different operations. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1079-1087. doi: 10.7507/1007-4848.201902021 Copy

1.	Siewert JR, Stein HJ. Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg, 1998, 85(11): 1457-1459.
2.	Rice TW, Ishwaran H, Ferguson MK, et al. Cancer of the esophagus and esophagogastric junction: An eighth edition staging primer. J Thorac Oncol, 2017, 12(1): 36-42.
3.	Rice TW, Rusch VW, Apperson-Hansen C, et al. Worldwide esophageal cancer collaboration. Dis Esophagus, 2009, 22(1): 1-8.
4.	Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol, 2010, 17(7): 1721-1724.
5.	Shen C, Yang H, Zhang B, et al. Changes of quality of life after gastric tube reconstruction in adenocarcinoma of the esophagogastric junction. Pak J Med Sci, 2013, 29(5): 1193-1198.
6.	Nafteux P, Durnez J, Moons J, et al. Assessing the relationships between health-related quality of life and postoperative length of hospital stay after oesophagectomy for cancer of the oesophagus and the gastro-oesophageal junction. Eur J Cardiothorac Surg, 2013, 44(3): 525-533.
7.	Oñate-Ocaña LF, Velázquez-Monroy N, Vázquez L, et al. Clinical validation of the EORTC QLQ-OG25 questionnaire for the evaluation of health-related quality of life in Mexican patients with esophagogastric cancers. Psychooncology, 2012, 21(7): 745-753.
8.	王金栋, 刘俊峰, 王其彰, 等. 食管癌贲门癌术后生活质量评价和影响因素分析. 中华胸心血管外科杂志, 2008, 24(1): 36-38.
9.	刘愉, 徐惠绵, 崔凯, 等译. 食管胃外科常规手术操作要领与技巧. 人民卫生出版社, 2014. 129-148.
10.	万崇华, 陈明清, 张灿珍, 等. 癌症患者生命质量测定量表EORTC QLQ -C30中文版评介. 实用肿瘤杂志, 2005, 20(04): 353-355.
11.	刘伟琳, 杨沫, 吴文悦, 等. EORTC QLQ-OG 25的介绍及发展. 当代医学, 2014, 20(15): 17-18.
12.	Blank S, Schmidt T, Heger P, et al. Surgical strategies in true adenocarcinoma of the esophagogastric junction (AEG Ⅱ): thoracoabdominal or abdominal approach? Gastric Cancer, 2018, 21(2): 303-314.
13.	Curtis NJ, Noble F, Bailey IS, et al. The relevance of the Siewert classification in the era of multimodal therapy for adenocarcinoma of the gastro-oesophageal junction. J Surg Oncol, 2014, 109(3): 202-207.
14.	Rüdiger Siewert J, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg, 2000, 232(3): 353-361.
15.	Feith M, Stein HJ, Siewert JR. Adenocarcinoma of the esophagogastric junction: surgical therapy based on 1602 consecutive resected patients. Surg Oncol Clin N Am, 2006, 15(4): 751-764.
16.	Apisarnthanarax S, Tepper JE. Crossroads in the combined-modality management of gastroesophageal junction carcinomas. Gastrointest Cancer Res, 2008, 2(5): 235-243.
17.	Djärv T, Lagergren J, Blazeby JM, et al. Long-term health-related quality of life following surgery for oesophageal cancer. Br J Surg, 2008, 95(9): 1121-1126.
18.	Avery K, Hughes R, McNair A, et al. Health-related quality of life and survival in the 2 years after surgery for gastric cancer. Eur J Surg Oncol, 2010, 36(2): 148-154.
19.	付茂勇, 黄涛, 任权, 等. 胃食管吻合术后胃食管反流症状的特征与相关因素的关系. 中国胸心血管外科临床杂志, 2007, 14(6): 476-477.
20.	Viklund P, Lindblad M, Lagergren J. Influence of surgery-related factors on quality of life after esophageal or cardia cancer resection. World J Surg, 2005, 29(7): 841-848.
21.	Karanicolas PJ, Graham D, Gönen M, et al. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg, 2013, 257(6): 1039-1046.
22.	Fuchs H, Hölscher AH, Leers J, et al. Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy? Gastric Cancer, 2016, 19(1): 312-317.
23.	Tomaszewski KA, Püsküllüoğlu M, Biesiada K, et al. Main influencing factors and health-related quality of life issues in patients with oesophago-gastric cancer - as measured by EORTC tools. Contemp Oncol (Pozn), 2013, 17(3): 311-316.
24.	Racine M, Tousignant-Laflamme Y, Kloda LA, et al. A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men? Pain, 2012, 153(3): 602-618.
25.	Chmielowska K, Tomaszewski KA, Pogrzebielski A, et al. Translation and validation of the Polish version of the EORTC QLQ-OPT30 module for the assessment of health-related quality of life in patients with uveal melanoma. Eur J Cancer Care (Engl), 2013, 22(1): 88-96.
26.	李林峻, 吴庆琛, 张诚, 等. 食管癌切除不同消化道重建方式术后患者生命质量对比分析. 中华医学杂志, 2013, 93(35): 2790-2793.
27.	Terashima T, Homma S, Watanabe N, et al. Motor and electrogastrographic activity of the gastric tube formed after esophagectomy. J Smooth Muscle Res, 2005, 41(2): 99-106.
28.	Panebianco V, Francioni F, Anzidei M, et al. Magnetic resonance-fluoroscopy as long-term follow-up examination in patients with narrow gastric tube reconstruction after radical esophagectomy. Eur J Cardiothorac Surg, 2006, 30(4): 663-668.
29.	杨纪林. 食管癌切除术中管状胃与全胃代食管对患者术后生活质量影响的对比研究. 实用癌症杂志, 2014, 29(11): 1428-1430.
30.	沈朝勇, 陈海宁, 张波, 等. 管状胃吻合对食管胃结合部腺癌患者术后生活质量的影响. 四川大学学报(医学版), 2014, 45(4): 717-719, 723.
31.	Ichikawa D, Komatsu S, Kubota T, et al. Long-term outcomes of patients who underwent limited proximal gastrectomy. Gastric Cancer, 2014, 17(1): 141-145.
32.	Xiao JW, Liu ZL, Ye PC, et al. Clinical comparison of antrum-preserving double tract reconstruction vs roux-en-Y reconstruction after gastrectomy for Siewert types Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction. World J Gastroenterol, 2015, 21(34): 9999-10007.

1. Siewert JR, Stein HJ. Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg, 1998, 85(11): 1457-1459.
2. Rice TW, Ishwaran H, Ferguson MK, et al. Cancer of the esophagus and esophagogastric junction: An eighth edition staging primer. J Thorac Oncol, 2017, 12(1): 36-42.
3. Rice TW, Rusch VW, Apperson-Hansen C, et al. Worldwide esophageal cancer collaboration. Dis Esophagus, 2009, 22(1): 1-8.
4. Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol, 2010, 17(7): 1721-1724.
5. Shen C, Yang H, Zhang B, et al. Changes of quality of life after gastric tube reconstruction in adenocarcinoma of the esophagogastric junction. Pak J Med Sci, 2013, 29(5): 1193-1198.
6. Nafteux P, Durnez J, Moons J, et al. Assessing the relationships between health-related quality of life and postoperative length of hospital stay after oesophagectomy for cancer of the oesophagus and the gastro-oesophageal junction. Eur J Cardiothorac Surg, 2013, 44(3): 525-533.
7. Oñate-Ocaña LF, Velázquez-Monroy N, Vázquez L, et al. Clinical validation of the EORTC QLQ-OG25 questionnaire for the evaluation of health-related quality of life in Mexican patients with esophagogastric cancers. Psychooncology, 2012, 21(7): 745-753.
8. 王金栋, 刘俊峰, 王其彰, 等. 食管癌贲门癌术后生活质量评价和影响因素分析. 中华胸心血管外科杂志, 2008, 24(1): 36-38.
9. 刘愉, 徐惠绵, 崔凯, 等译. 食管胃外科常规手术操作要领与技巧. 人民卫生出版社, 2014. 129-148.
10. 万崇华, 陈明清, 张灿珍, 等. 癌症患者生命质量测定量表EORTC QLQ -C30中文版评介. 实用肿瘤杂志, 2005, 20(04): 353-355.
11. 刘伟琳, 杨沫, 吴文悦, 等. EORTC QLQ-OG 25的介绍及发展. 当代医学, 2014, 20(15): 17-18.
12. Blank S, Schmidt T, Heger P, et al. Surgical strategies in true adenocarcinoma of the esophagogastric junction (AEG Ⅱ): thoracoabdominal or abdominal approach? Gastric Cancer, 2018, 21(2): 303-314.
13. Curtis NJ, Noble F, Bailey IS, et al. The relevance of the Siewert classification in the era of multimodal therapy for adenocarcinoma of the gastro-oesophageal junction. J Surg Oncol, 2014, 109(3): 202-207.
14. Rüdiger Siewert J, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg, 2000, 232(3): 353-361.
15. Feith M, Stein HJ, Siewert JR. Adenocarcinoma of the esophagogastric junction: surgical therapy based on 1602 consecutive resected patients. Surg Oncol Clin N Am, 2006, 15(4): 751-764.
16. Apisarnthanarax S, Tepper JE. Crossroads in the combined-modality management of gastroesophageal junction carcinomas. Gastrointest Cancer Res, 2008, 2(5): 235-243.
17. Djärv T, Lagergren J, Blazeby JM, et al. Long-term health-related quality of life following surgery for oesophageal cancer. Br J Surg, 2008, 95(9): 1121-1126.
18. Avery K, Hughes R, McNair A, et al. Health-related quality of life and survival in the 2 years after surgery for gastric cancer. Eur J Surg Oncol, 2010, 36(2): 148-154.
19. 付茂勇, 黄涛, 任权, 等. 胃食管吻合术后胃食管反流症状的特征与相关因素的关系. 中国胸心血管外科临床杂志, 2007, 14(6): 476-477.
20. Viklund P, Lindblad M, Lagergren J. Influence of surgery-related factors on quality of life after esophageal or cardia cancer resection. World J Surg, 2005, 29(7): 841-848.
21. Karanicolas PJ, Graham D, Gönen M, et al. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort study. Ann Surg, 2013, 257(6): 1039-1046.
22. Fuchs H, Hölscher AH, Leers J, et al. Long-term quality of life after surgery for adenocarcinoma of the esophagogastric junction: extended gastrectomy or transthoracic esophagectomy? Gastric Cancer, 2016, 19(1): 312-317.
23. Tomaszewski KA, Püsküllüoğlu M, Biesiada K, et al. Main influencing factors and health-related quality of life issues in patients with oesophago-gastric cancer - as measured by EORTC tools. Contemp Oncol (Pozn), 2013, 17(3): 311-316.
24. Racine M, Tousignant-Laflamme Y, Kloda LA, et al. A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men? Pain, 2012, 153(3): 602-618.
25. Chmielowska K, Tomaszewski KA, Pogrzebielski A, et al. Translation and validation of the Polish version of the EORTC QLQ-OPT30 module for the assessment of health-related quality of life in patients with uveal melanoma. Eur J Cancer Care (Engl), 2013, 22(1): 88-96.
26. 李林峻, 吴庆琛, 张诚, 等. 食管癌切除不同消化道重建方式术后患者生命质量对比分析. 中华医学杂志, 2013, 93(35): 2790-2793.
27. Terashima T, Homma S, Watanabe N, et al. Motor and electrogastrographic activity of the gastric tube formed after esophagectomy. J Smooth Muscle Res, 2005, 41(2): 99-106.
28. Panebianco V, Francioni F, Anzidei M, et al. Magnetic resonance-fluoroscopy as long-term follow-up examination in patients with narrow gastric tube reconstruction after radical esophagectomy. Eur J Cardiothorac Surg, 2006, 30(4): 663-668.
29. 杨纪林. 食管癌切除术中管状胃与全胃代食管对患者术后生活质量影响的对比研究. 实用癌症杂志, 2014, 29(11): 1428-1430.
30. 沈朝勇, 陈海宁, 张波, 等. 管状胃吻合对食管胃结合部腺癌患者术后生活质量的影响. 四川大学学报(医学版), 2014, 45(4): 717-719, 723.
31. Ichikawa D, Komatsu S, Kubota T, et al. Long-term outcomes of patients who underwent limited proximal gastrectomy. Gastric Cancer, 2014, 17(1): 141-145.
32. Xiao JW, Liu ZL, Ye PC, et al. Clinical comparison of antrum-preserving double tract reconstruction vs roux-en-Y reconstruction after gastrectomy for Siewert types Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction. World J Gastroenterol, 2015, 21(34): 9999-10007.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comparison of quality of life in patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction treated by three different operations

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