PROSPERO

International prospective register of systematic reviews

Surgical treatment of adenocarcinoma of the gastroesophageal junction: a systematic

review and meta-analysis
Patrick Heger, Susanne Blank, Kathrin Grummich, Markus K. Diener, Markus W. Büchler, Thomas Schmidt,
André L. Mihaljevic

Citation
Patrick Heger, Susanne Blank, Kathrin Grummich, Markus K. Diener, Markus W. Büchler, Thomas
Schmidt, André L. Mihaljevic. Surgical treatment of adenocarcinoma of the gastroesophageal
junction: a systematic review and meta-analysis. PROSPERO 2016 CRD42016036476 Available
from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016036476

Review question
The aims of this systematic review are:1. To compare the rates of negative resection margins and extent of
lymphadenectomy within the two different surgical approaches for AEG.
2. To compare both therapies with regard to postoperative morbidity and mortality.

Searches
We will search the following databases: MEDLINE via Pubmed, The Cochrane Library (Cochrane Database
of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Web of
Science.
Exemplary search for MEDLINE:
((((((((oesophagogastr* junction) OR esophagogastr* junction) OR gastrooesophag* junction) OR
gastroesophag* junction) OR siewert) OR aeg) OR adenocarcinoma)) AND ((((((((((((gastr* operation) OR
gastr* surger*) OR gastr* resect*) OR gastrectom*) OR oesphag* operation) OR esophag* operation*) OR
oesophag* surger*) OR esophag* surger*) OR oesophag* resect*) OR esophag* resect*) OR
oesophagectom*) OR esophagectom*)
There will be no language restrictions or other restrictions.

Types of study to be included

Inclusion criteria:Randomised controlled trials, prospective trials, retrospective analyses.Exclusion
criteria:Case series, case reports.

Condition or domain being studied

All trials are studies comparing the thoracoabdominal and the transhiatal extended approach for therapy of
adenocarcinoma of the esophagogastric junction.

Participants/population
Patients undergoing surgical therapy for AEG via thoracoabdominal esophagectomy or transhiatally
extended gastrectomy.

Intervention(s), exposure(s)
Inclusion criteria:
- Trials comparing the thoracoabdominal esophagectomy and the transhiatally extended gastrectomy for
surgical therapy of AEG.
- RCTs, prospective and retrospective studies.
Exclusion criteria:
- Case series, case reports.
- Studies not comparing the two approaches of interest.

Comparator(s)/control
Comparison of the two approaches of interest.

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International prospective register of systematic reviews

Primary outcome(s)
The number of dissected lymph nodes.

Secondary outcome(s)
Negative resection margins, postoperative morbidity, rate of anastomotic leakage, postoperative mortality, all
forms of survival (disease-free survival, overall survival...).

Data extraction (selection and coding)

Two authors (PH and SB) will independently review the title and abstract of all records as well as the full
texts of all articles assessed for eligibility. In case of disagreement, a third reviewer (AM) will be consulted
and the decision regarding inclusion will be made after discussion.

Risk of bias (quality) assessment

Risk of bias will be assessed using the Cochrane risk of bias tool for RCTs and the Downs and Black criteria
for non-RCTs.

Strategy for data synthesis

Data extraction will be done by two authors independently (PH and SB). In case of disagreement a third
reviewer (AM) will be consulted and decision will be made after discussion regarding the data.

Analysis of subgroups or subsets

Where possible, subgroup analysis for AEG type II will be made.

Contact details for further information

Patrick Heger
patrick.heger@med.uni-heidelberg.de

Organisational affiliation of the review

None

Review team members and their organisational affiliations

Dr Patrick Heger. Department of General, Visceral and Transplantation Surgery, University of Heidelberg
Dr Susanne Blank. Department of General, Visceral and Transplantation Surgery, University of Heidelberg
Ms Kathrin Grummich. The Study Center of the German Surgical Society (SDGC), University of Heidelberg,
Heidelberg
Professor Markus K. Diener. Department of General, Visceral and Transplantation Surgery, University of
Heidelberg
Professor Markus W. Büchler. Department of General, Visceral and Transplantation Surgery, University of
Heidelberg
Dr Thomas Schmidt. Department of General, Visceral and Transplantation Surgery, University of Heidelberg
Dr André L. Mihaljevic. Department of General, Visceral and Transplantation Surgery, University of
Heidelberg

Anticipated or actual start date

14 March 2016

Anticipated completion date

01 June 2016

Funding sources/sponsors
None

Conflicts of interest
None known

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International prospective register of systematic reviews

Language
English

Country
Germany

Stage of review
Review_Completed_not_published

Subject index terms status

Subject indexing assigned by CRD

Subject index terms

Adenocarcinoma; Digestive System Surgical Procedures; Esophagogastric Junction; Humans; Treatment
Outcome

Date of registration in PROSPERO

14 March 2016

Date of publication of this version

31 March 2017

Revision note for this version

Update on stage of review

Details of any existing review of the same topic by the same authors
Stage of review at time of this submission

Stage Started Completed

Preliminary searches Yes Yes

Piloting of the study selection process Yes Yes

Formal screening of search results against eligibility criteria Yes Yes

Data extraction Yes Yes

Risk of bias (quality) assessment Yes Yes

Data analysis Yes Yes

Revision note
Update on stage of review

Versions
14 March 2016
20 May 2016
31 March 2017

PROSPERO
This information has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration

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International prospective register of systematic reviews

record, any associated files or external websites.

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