RT Book, Section
A1 Kukar, Moshim
A1 Hochwald, Steven N.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145761446
T1 Special Operative and Multimodal Therapy Considerations in EGJ Cancer Care: Western Viewpoints
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145761446
RD 2024/04/16
AB Management  of  Esophago-Gastric  Junction  (EGJ)  cancer  with  locoregional  disease  is  an  area  of  ongoing  discussion  and  debate,  since  there  is  a  paucity  of  randomized  trials  focusing  exclusively  on  EGJ  cancer.  Most  of  the  data  that  guide  the  multimodality  treatment  of  EGJ  adenocarcinoma  are  derived  from  trials  that  involve  predominantly  gastric  or  esophageal  cancers.  Within  the  trials  designed  primarily  for  gastric  cancer,  patients  with  EGJ  tumors  have  accounted  for  only  about  20%  of  all  enrollees.  There  are  epidemiologic  and  pathobiologic  differences  between  EGJ  and  noncardia  gastric  adenocarcinomas  that  raise  concern  as  to  whether  results  from  predominantly  gastric  cancer  trials  can  be  extrapolated  to  EGJ  tumors.  Similarly,  there  are  histological  differences  amongst  distal  esophageal  and  EGJ  tumors.  In  Siewert’s  original  description,  he  recommended  that  Type  1  EGJ  cancers  should  be  treated  as  esophageal  and  Type  2  and  3  treated  as  gastric  cancer.1,2  NCCN  guidelines  based  on  the  seventh  edition  of  the  AJCC  staging  recommends  Type  1  and  2  tumors  to  be  staged  and  treated  as  esophageal  cancer  and  Type  3  as  gastric  cancer.3,4  In  the  following  review,  we  will  discuss  the  available  data  supporting  the  operative  and  multimodality  management  of  EGJ  cancers.