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

This study is comparing two surgical approaches for treating a specific type of stomach/esophagus junction cancer (Siewert type II–III) that has grown locally but not widely spread: removing only the upper portion of the stomach (proximal gastrectomy) versus removing the entire stomach (total gastrectomy). The goal is to find out which surgery leads to better outcomes and quality of life. **You may be eligible if...** - You are aged 18–90 with a confirmed diagnosis of locally advanced Siewert type II or III gastroesophageal junction cancer (cancer where the esophagus meets the stomach) - A specialist team has confirmed you are fit for surgery - You are a candidate for curative surgery with thorough lymph node removal (D2 dissection) - You can provide written informed consent **You may NOT be eligible if...** - Your cancer is at an early stage - Your tumor is in a different part of the stomach (antrum or corpus) - You are at very high risk from anesthesia (ASA class IV or higher) - You are pregnant - You are unable or unwilling to consent Talk to your doctor to see if this trial is right for you.