Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategies

Hasegawa, Shin; Yoshikawa, Takaki

doi:10.1007/s10120-010-0555-2

Cited by 127 publications

(122 citation statements)

References 70 publications

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“…Most cases of carcinoma of the EGJ are detected at an advanced stage and thus show a poor prognosis [1,2]. The most frequent sites of lymph node metastasis in carcinoma of the EGJ differ from carcinomas in other portions of the gastric tract and esophageal cancers, and a thoracic approach is sometimes taken during surgery.…”

Section: Introductionmentioning

confidence: 99%

A Case of Alpha-Fetoprotein-Producing Adenocarcinoma of the Esophagogastric Junction in which Long-Term Survival Was Achieved by Means of Individualized Multidisciplinary Therapy

Tanaka

Fujiya

Ijiri

et al. 2018

J Gastrointest Canc

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Section: Introductionmentioning

confidence: 99%

A Case of Alpha-Fetoprotein-Producing Adenocarcinoma of the Esophagogastric Junction in which Long-Term Survival Was Achieved by Means of Individualized Multidisciplinary Therapy

Tanaka

Fujiya

Ijiri

et al. 2018

J Gastrointest Canc

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“…Lung metastasis was diagnosed in 7-41 % of the patients with advanced esophageal cancer, and its frequency was high compared with about 5 % of patients diagnosed with advanced gastric cancer [12,[21][22][23]. Because of invasion to the esophagus, AEGJ may have the same drainage system of a vein as lower esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparison of advanced adenocarcinomas of esophagogastric junction and distal stomach in Japanese patients

et al. 2013

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Background There have been no reports on the incidence, characteristics, treatment outcomes, and prognosis of inoperably advanced or recurrent adenocarcinoma of the esophagogastric junction (AEGJ) in Japan. Methods We investigated the clinicopathological characteristics, treatment outcomes, and prognosis for 816 patients with esophagogastric junctional and gastric adenocarcinoma who received first-line chemotherapy between 2004 and 2009. Results Of 816 patients, 82 (10 %) had AEGJ. The patients with AEGJ had significantly more lung and lymph node metastasis, but less peritoneal metastasis, than those with gastric adenocarcinoma (GAC). The objective response rate to first-line chemotherapy was 23.3 % for patients with AEGJ and 22.6 % in patients with GAC (p = 0.90). The median survival was 13.0 months in AEGJ and 11.8 months in GAC (p = 0.445). In no patient was tumor site a significant prognostic factor (p = 0.472). In patients with AEGJ, ECOG PS C 2, presence of liver metastasis, and absence of lung metastasis were significantly associated with poor prognosis. Conclusions No significant differences were observed in treatment outcomes between advanced AEGJ and GAC. Therefore, the same chemotherapy regimen can be given as a treatment arm in future Japanese clinical trials to both patients with inoperably advanced or recurrent AEGJ and those with GAC.

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“…First, the proportions of the three subtypes are very different in Eastern and Western series: the proportions are almost equal in European series, whereas most EGJ tumors in Korea and Japan are Siewert types II and III (the proportion of Siewert type I is\4%) [8]. These differences are very likely due to the higher prevalence of reflux-related conditions in Western countries.…”

Section: Introductionmentioning

confidence: 98%

Western strategy for EGJ carcinoma

et al. 2016

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In this paper, the epidemiological and clinicobiological behavior of esophagogastric junction (EGJ) adenocarcinoma in the West is compared and contrasted to that in the East, and an overview is provided of current therapeutic strategies employed for this type of tumor in Western countries. It is well known that multimodal treatment is the therapeutic standard in locally advanced EGJ adenocarcinoma, but whether neoadjuvant/perioperative chemotherapy (CT) or neoadjuvant chemoradiotherapy (CRT) is the optimal approach is still debated. Neoadjuvant CRT improves local control in locally advanced Siewert type I and II tumors, so it should be considered the treatment of choice. In the subset of these patients with microscopic systemic disease at diagnosis, more intensive exclusive chemotherapy protocols could be of benefit. Therefore, there is an urgent need to identify these patients before planning the treatment. For Siewert type III tumors, perioperative chemotherapy is the standard. While there is general agreement on the optimal surgical approach for Siewert types I and III (a two-field Ivor Lewis operation and a total gastrectomy with distal esophagectomy, respectively), no standard surgical treatment has been defined for Siewert type II tumors. When data from Western series on proximal and circumferential resection margins and on nodal spread in Siewert type II tumors are taken into account, the optimal surgical approach appears to be Ivor Lewis esophagectomy. Whether the extent of esophageal invasion can correctly predict nodal involvement in middle-upper mediastinal stations as a means to restrict indications for transthoracic esophagectomy requires further investigation in the West.

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Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategies

Cited by 127 publications

References 70 publications

A Case of Alpha-Fetoprotein-Producing Adenocarcinoma of the Esophagogastric Junction in which Long-Term Survival Was Achieved by Means of Individualized Multidisciplinary Therapy

A Case of Alpha-Fetoprotein-Producing Adenocarcinoma of the Esophagogastric Junction in which Long-Term Survival Was Achieved by Means of Individualized Multidisciplinary Therapy

Comparison of advanced adenocarcinomas of esophagogastric junction and distal stomach in Japanese patients

Western strategy for EGJ carcinoma

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