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Esophageal carcinomas have increased in incidence over the past few decades. Adenocarcinomas of the gastroesophageal junction (Siewert type II tumors) are a special subtype of esophageal carcinoma. In most cases, these tumors are treated with chemo(radio)therapy followed by surgery. Since the Siewert type II tumors are located exactly at the junction between esophagus and stomach, two different procedures can be considered for the operation: the so-called transthoracic esophagectomy (TTE) with gastric tube reconstruction or transhiatal extended gastrectomy (TEG) with Roux-en-Y reconstruction.

During TTE, a large part of the esophagus is removed along with the gastroesophageal junction. To create the gastric tube reconstruction, the stomach is then formed into a tube and connected to the remaining esophagus in the chest cavity. During the other operation, the TEG, the stomach is removed along with the gastroesophageal junction. To create the Roux-en-Y reconstruction, an anastomosis between the esophagus and part of the small intestine is formed. Both surgical procedures allow for complete removal of the tumor and the surrounding lymph nodes, which is the aim of the operation. Both operations are safe to perform, but they may lead to complications.

So far, it has not yet been scientifically proven which of the two operations is better suited for treating Siewert type II tumors. Both operations are recommended as equivalent treatment methods in current treatment guidelines. The aim of the randomized controlled CARDIA-trial is therefore to compare these two procedures (TTE versus TEG) in terms of oncological efficacy, postoperative recovery and quality of life. As a result of the CARDIA-trial, all future patients with Siewert type II tumors can be offered the best possible surgical procedure with a solid scientific basis.

The trial was designed and carried out by the Clinic for General, Visceral and Tumor Surgery at the University Hospital Cologne and the University Medical Center Utrecht in cooperation with the Center for Clinical Studies (ZKS) and the Institute for Medical Statistics and Bioinformatics at the University of Cologne. We hope that this website will be able to answer any questions you may have about our study. If you need any further information, please do not hesitate to get in touch with our medical coordinators.