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Long-Term Survival Comparing Carcinoma of the Gastroesophageal Junction With Gastric Cancer - Results of the German Gastric Cancer Study 2
Ralf Steinert2, Ingo Gastinger3, Karsten Ridwelski4, Henry Ptok5, Meyer Frank*1, Ronny Otto6, Hans Lippert6
1Dept. of General, Abdominal & Vascular Surgery, University Hospital, Magdeburg, Germany; 2Dept. of General and Abdominal Surgery, St.-Josef Hospital Salzkotten, Salzkotten, Germany; 3Oncosurgical practice, Cottbus, Germany; 4Dept. of General and Abdominal Surgery, Municipal Hospital, Magdeburg, Germany; 5Dept. of Surgery, Municipal Hospital, Cottbus, Germany; 6Institute of Quality Assurance, Otto-von-Guericke University, Magdeburg, Germany
Introduction: Data obtained in multicenter studies on quality assurance can reflect the current situation in the treatment of gastric cancer. Adenocarcinoma of the gastroesophageal junction (AGJ) appears to be a separate tumor entity.
Methods: Perioperative data on the diagnostic and therapeutic management in gastric cancer patients were collected by means of a prospective multicenter observational study "QCGC 2" from 01/01/2007 to 12/31/2009. Early postoperative treatment results and long-term oncological outcome in patients with AGJ with those of the stomach were compared.
Results: 2,897 patients with gastric cancer out of 141 hospitals of each profile were enrolled in the study; out of them, 2,788 (96.2 %) underwent surgical intervention. With regard to tumor site, 544 cases with AGJ were operated within 108/141 hospitals (76.6 %) only. Patients with AGJ showed a significantly shorter median survival (25 months) depending on the tumor stage compared with subjects suffering from gastric cancer (38 months). Overall 5-year survival rate of AGJ patients ( 33.1 %) was significantly worse compared with that of individuals with gastric cancer (41.4 %) also depending on single tumor stages according to UICC classification (p<0.001): stage II (46.3 % versus 50 %), III (0 % vs. 22 %) and IV (7.4 % vs. 12 %).
Conclusion: The treatment results of gastric cancer patients in hospitals of each profile cannot be satisfying despite a multimodal approach. Prognosis of the carcinoma of the gastroesophageal junction is significantly worse compared with other gastric tumor sites. A centralization of surgical management of these patients seems to be reasonable.
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