Esophagogastric junction adenocarcinoma and its surgical resolution in Guayaquil, Ecuador

Abstract

Introduction: Adenocarcinoma is the most frequent cancer in the stomach, one of the main causes of the poor survival of these patients is the possibility or not of achieving a complete surgical tumor resection due to its location or invasion. Siewert describes cardial tumors and this topography generates a challenge for its therapeutic approach, due to its anatomical relationships. The aim is to identify the correlation between the surgical technique and the survival of the patient with adenocarcinoma according to Siewert. Methods: A descriptive, correlational, retrospective study was carried out in 17 patients diagnosed with gastric adenocarcinoma according to Siewert from January 2011 to April 2018. The variables age, gender, oncological stage, neoadjuvant, surgical, adjuvant, localization were analyzed. tumor differentiation and infiltration, postsurgical complications and current situation of the patient. The statistical association was determined by the Chi square test and the Spearman coefficient for a level of significance of (p <0.05). Results: The most frequent location was Siewert Type III in eleven patients (64.7%), the majority of patients attended was in clinical stage III, the total gastrectomy was the most used technique with 10 patients (67.9%), the reconstruction was in Roux-en-Y 70.59%, the complications were not related to the surgery, the superior survival was 27 months after the total gastrectomy, the complications were not related to the surgery. Conclusion: Patients with gastric cancer according to Siewert will require a complete resection with safety oncological margins. The diagnosis of this disease is still late and radical and non-partial surgical techniques should be used. Patients with Siewert I and II will have greater esophageal involvement, which impoverishes their prognosis due to its own characteristics, unlike Siewert III. Survival presents correlation with the tumor location, initial clinical stage and with the surgical technique that fulfills a complete removal and safety oncological margins.