{
  "abstract": "Background The optimal surgical strategy for adenocarcinoma of oesophagogastric junction (AEG) remains debated, particularly regarding lymphadenectomy extent, gastrectomy type and surgical approach, with real-world prospective evidence being scarce.Objective To map lymph node metastasis (LNM) patterns and assess surgical outcomes in a large multicentre cohort of patients with AEG undergoing radical resection.Design The Chinese League of Adenocarcinoma of Esophagogastric Junction (CLAEG) registry, initiated in 2022 across 44 high-volume Chinese centres, prospectively enrolled AEG patients. This analysis included 2044 radical resections, with LNM assessed by station, stratified by Siewert type and neoadjuvant therapy. Surgical outcomes were compared between total versus proximal gastrectomy and laparoscopic versus open resection.Results Most tumours were Siewert type II (64.6%) or III (33.4%). LNM was substantially higher in abdominal than mediastinal stations; category-1 nodes (metastasis, >10%) comprised stations 1, 2, 3, 4, 7, 8a, 9 and 11p. The LNM rates for mediastinal stations were 2.77% (No. 110), 0.71% (No. 111) and 0.68% (No. 112). Patients who received neoadjuvant therapy had lower LNM rates, indicating nodal downstaging. Among those undergoing gastrectomy, patients who underwent total gastrectomy had a lower postoperative complication rate than those who underwent proximal gastrectomy (14.8% vs 21.0%; p=0.001) and achieved more extensive lymphadenectomy. Compared with open surgery, patients who underwent laparoscopic resection experienced faster postoperative recovery without higher complication rates (16.5% vs 17.3%). No perioperative mortality occurred.Conclusion The CLAEG study shows that abdominal lymphadenectomy should be prioritised in AEG, with neoadjuvant therapy, total gastrectomy and laparoscopy associated with favourable short-term outcomes.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Jiabin Zheng"
    },
    {
      "affiliations": [
        "Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Yuanfang Li"
    },
    {
      "affiliations": [
        "Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China"
      ],
      "name": "Lin Fan"
    },
    {
      "affiliations": [
        "Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China"
      ],
      "name": "Chaohui Zheng"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, People's Republic of China"
      ],
      "name": "Su Yan"
    },
    {
      "affiliations": [
        "Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China"
      ],
      "name": "Ziyu Li"
    },
    {
      "affiliations": [
        "Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Hao Chen"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Changzhi People′s Hospital Affiliated to Changzhi Medical College, Shanxi Provincial Clinical Medical Research Center for Malignant Tumor (Esophagogastric Junction Cancer), Changzhi, Shanxi, People's Republic of China"
      ],
      "name": "Wenqing Hu"
    },
    {
      "affiliations": [
        "Department of Digestive Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, People's Republic of China"
      ],
      "name": "Jiangpeng Wei"
    },
    {
      "affiliations": [
        "Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China"
      ],
      "name": "Quan Wang"
    },
    {
      "affiliations": [
        "Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China"
      ],
      "name": "Zhi Li"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China"
      ],
      "name": "Wenbin Zhang"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Oncological Surgery, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, People's Republic of China"
      ],
      "name": "Weidong Zang"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China"
      ],
      "name": "Wenbin Yu"
    },
    {
      "affiliations": [
        "Department of General Surgery (Stomach Surgery Unit I), Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Lei Lian"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People's Republic of China"
      ],
      "name": "Zhaojian Niu"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China"
      ],
      "name": "Yongyou Wu"
    },
    {
      "affiliations": [
        "Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China"
      ],
      "name": "Yigao Wang"
    },
    {
      "affiliations": [
        "Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, China Medical University, Shenyang, Liaoning, People's Republic of China"
      ],
      "name": "Jia-Ming Zhu"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China"
      ],
      "name": "Shengxun Mao"
    },
    {
      "affiliations": [
        "Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China"
      ],
      "name": "Bo Wei"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Key Laboratory of Engineering of Shandong Province, Shandong Provincial Hospital, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China"
      ],
      "name": "Changqing Jing"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People's Republic of China"
      ],
      "name": "Kuan Wang"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Clinical Research Academy of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Wei Wang"
    },
    {
      "affiliations": [
        "Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China"
      ],
      "name": "Linghua Zhu"
    },
    {
      "affiliations": [
        "Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, People's Republic of China"
      ],
      "name": "Kewei Jiang"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Yuedong Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Meizhou, Guangdong, People's Republic of China"
      ],
      "name": "Bo Wei"
    },
    {
      "affiliations": [
        "Department of Digestive Surgery, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China"
      ],
      "name": "Zhengrong Li"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Oncology Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, People's Republic of China"
      ],
      "name": "Jun You"
    },
    {
      "affiliations": [
        "2nd Abdominal Surgery Department, Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China"
      ],
      "name": "Bo Yi"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China"
      ],
      "name": "Jian Zhang"
    },
    {
      "affiliations": [
        "Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, ChinaShanghai Minimally Invasive Surgery Center, Shanghai, People's Republic of China"
      ],
      "name": "Lu Zang"
    },
    {
      "affiliations": [
        "Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China",
        "Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China"
      ],
      "name": "Hua Huang"
    },
    {
      "affiliations": [
        "Department of General Surgery, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China"
      ],
      "name": "Shaobin Duan"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan, Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China"
      ],
      "name": "Gaoping Zhao"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Second Affiliate Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Guoqiang Wang"
    },
    {
      "affiliations": [
        "Department of General Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China"
      ],
      "name": "Pin Liang"
    },
    {
      "affiliations": [
        "Gastrointestinal Surgery Department, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Wu Song"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Fanghai Han"
    },
    {
      "affiliations": [
        "Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China"
      ],
      "name": "Hankun Hao"
    },
    {
      "affiliations": [
        "Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China",
        "Second Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China"
      ],
      "name": "Fenglin Liu"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China"
      ],
      "name": "He Huang"
    },
    {
      "affiliations": [
        "Department of Colorectal Surgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China"
      ],
      "name": "Qingxing Huang"
    },
    {
      "affiliations": [
        "Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Yong Li"
    }
  ],
  "title": "Prospective evaluation of radical surgery for adenocarcinoma of oesophagogastric junction: real-world insights from the CLAEG study",
  "uid": "e9b563ab-6443-5fb5-bbf8-6041665e7ecd"
}