RecruitingNot ApplicableNCT07482566

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

A Multicenter Prospective Randomized Double-Blind Clinical Trial Comparing Proximal Gastrectomy and Total Gastrectomy in Patients With Locally Advanced Siewert Type II-III Gastroesophageal Junction Cancer

Sponsor

Nurettin Şahin

Enrollment

120 participants

Start Date

Feb 1, 2026

Study Type

INTERVENTIONAL

Conditions

Gastroesophageal-junction Cancer Stomach Neoplasms Esophageal Neoplasms

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

Min Age: 18 YearsMax Age: 90 Years

Inclusion Criteria5

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 Criteria5

Early-stage gastroesophageal junction cancer
Gastric cancers located in the antrum or corpus
Severe anesthetic risk (ASA class IV or higher)
Pregnancy
Patients unwilling or unable to provide informed consent

Interventions

PROCEDUREProximal Gastrectomy

Proximal gastrectomy with D2 lymphadenectomy involving resection of the proximal stomach and gastroesophageal junction. Reconstruction will be performed using esophagogastric or esophagojejunal anastomosis according to surgeon preference. The procedure may be performed via open, laparoscopic, or robotic approach depending on patient suitability.

PROCEDURETotal Gastrectomy

Total gastrectomy with D2 lymphadenectomy involving complete removal of the stomach followed by esophagojejunal reconstruction. The surgical approach (open, laparoscopic, or robotic) will be selected according to patient suitability and surgeon preference.