Different time trend and management of esophagogastric junction adenocarcinoma in three Asian countries

Hatta, Waku; Tong, Daniel; Lee, Yeong Yeh; Ichihara, Shin; Uedo, Noriya; Gotoda, Takuji

doi:10.1111/den.12808

Cited by 37 publications

(29 citation statements)

References 70 publications

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“…This classification includes not only adenocarcinoma but also squamous cell carcinoma [9, 13]. On the other hand, Siewert type II tumors, located 1 cm above and 2 cm below the EGJ, are considered true cardiac adenocarcinomas arising from the EGJ epithelium [2, 9, 11, 13]. Barrett’s esophagus is defined as columnar epithelium that is replaced from stratified squamous epithelium of distal esophagus [1, 3, 13].…”

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

“…Detecting early EGJ adenocarcinoma is sometimes difficult because of the location of the growth and the subtle differences between the affected tissue and the surrounding mucosa [2, 5]. Patients are advised to inspire deeply, which reduces intrathoracic pressure and facilitates observation of the EGJ by distention of the lumen (Fig.…”

Section: Preoperative Diagnosismentioning

confidence: 99%

“…Subsquamous carcinoma extension, which is EGJ adenocarcinoma invasion beneath the normal esophageal squamous epithelium, is a clinical complication in ESD for EGJ adenocarcinoma [2, 4, 5]. This is because cancer margins on the oral side are difficult to detect when subsquamous carcinoma extension is not visible by endoscopy.…”

Section: Subsquamous Carcinoma Extensionmentioning

confidence: 99%

“…Surgical resection, including total gastrectomy with transhiatal resection and esophagectomy, has been performed for EGJ cancers [2, 3, 27]. Long-term outcomes for superficial cancers have been reported to be favorable.…”

Section: Other Treatmentmentioning

confidence: 99%

“…On the other hand, esophageal adenocarcinoma is rare, accounting for 1–4% of esophageal cancer in Eastern countries including Japan [2, 4, 5]. However, it is believed that the incidence of adenocarcinoma of the EGJ will increase in Asia in the future due to a decreasing incidence of Helicobacter pylori infection [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

et al. 2018

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Background: Adenocarcinoma of the esophagogastric junction (EGJ) is uncommon in Eastern countries, including Japan, but it is believed that the incidence of EGJ adenocarcinoma will increase in Asia in the future due to the decreasing incidence of Helicobacter pylori infection. Endoscopic submucosal dissection (ESD) is a minimally invasive and curative treatment that allows precise pathological assessment. Summary: Magnifying endoscopy with narrow-band imaging may be useful for differential diagnoses and for delineating the cancer margin of EGJ adenocarcinoma, but subsquamous carcinoma extension, which is the invasion of EGJ adenocarcinoma beneath the normal esophageal squamous epithelium, makes it difficult to detect cancer margins of the oral side in ESD for EGJ adenocarcinoma. Since subsquamous carcinoma extension was reported to be less than 1 cm in most cases, the oral safety margin that is placed 1 cm from the squamocolumnar junction is useful for negative cancerous horizontal margin. A multicenter retrospective study of esophageal adenocarcinoma including EGJ adenocarcinoma showed that mucosal and submucosal cancer within 500 μm from the muscularis mucosa without lymphovascular involvement, a poorly differentiated component, and lesion size over 3 cm were not associated with metastasis. Several retrospective studies about ESD for EGJ adenocarcinoma have suggested feasible short-term and long-term outcomes using curative criteria based on gastric cancer guidelines. Key Messages: ESD would be a good first-line treatment for superficial EGJ adenocarcinoma, including Barrett’s adenocarcinoma. Additional information about the incidence of metastasis would help confirm the indication of ESD for EGJ adenocarcinoma.

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Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

Section: Preoperative Diagnosismentioning

confidence: 99%

Section: Subsquamous Carcinoma Extensionmentioning

confidence: 99%

Section: Other Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

et al. 2018

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Association of Helicobacter pylori and gastric atrophy with adenocarcinoma of the esophagogastric junction in Taixing, China

Gao

Cai

Yang

et al. 2021

Intl Journal of Cancer

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Gastric atrophy caused by Helicobacter pylori infection was suggested to influence the risk of adenocarcinoma of the esophagogastric junction (AEGJ), however, the evidence remains limited. We aimed to examine the associations of H. pylori infection and gastric atrophy (defined using serum pepsinogen [PG] I to PGII ratio) with AEGJ risk, based on a population‐based case‐control study in Taixing, China (2010‐2014), with 349 histopathologically confirmed AEGJ cases and 1859 controls. We explored the potential effect modification by H. pylori serostatus and sex on the association of serum PGs with AEGJ risk. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). H. pylori seropositivity was associated with an elevated AEGJ risk (OR = 1.95, 95% CI: 1.47‐2.63). Neither CagA‐positive nor VacA‐positive strains dramatically changed this association. Gastric atrophy (PGI/PGII ratio ≤4) was positively associated with AEGJ risk (OR = 2.36, 95% CI: 1.72‐3.22). The fully adjusted ORs for AEGJ progressively increased with the increasing levels of PGII (P‐trend <.001). H. pylori showed nonsignificant effect modification (P‐interaction = .385) on the association of gastric atrophy with AEGJ. In conclusion, H. pylori and gastric atrophy were positively associated with AEGJ risk. These results may contribute evidence to the ongoing research on gastric atrophy‐related cancers and guide the prevention and control of AEGJ.

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Clinical profile of patients presenting with dysphagia ‐ an experience from a tertiary care center in North India

et al. 2019

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Background and Aim Dysphagia can lead to substantial morbidity and mortality, especially in the elderly. It has both benign and malignant causes. Despite having a varied etiology, there have been few studies in India. Therefore, a study was undertaken to evaluate the clinical profile and various etiologies of dysphagia. Methods A prospective study was conducted on 220 patients with a complaint of dysphagia. Detailed history and examination, endoscopy and biopsies, and barium swallow were performed. Computed tomography and magnetic resonance imaging were performed wherever required. Patients who had an oropharyngeal or neurological cause of dysphagia were excluded. Results The mean age of patients was 57.2 years, with the male: female ratio being 1.7:1. Of the patients, 35% (78 patients) had malignant etiology, with a mean age of 65.2 years, and 65% (142 patients) had a benign etiology, with a mean age of 51 years. Among the patients with malignancy, 56 had squamous cell carcinoma of esophagus (71.7%), 20 had adenocarcinoma of esophagus (25.7%), and 2 had gastric cardia adenocarcinoma (2.6%). Malignancy was most commonly located in distal esophagus (48 patients), and among the cases, 18 had involvement of the gastroesophageal junction. The most common benign cause was esophagitis secondary to reflux in 25.5% (56 patients), followed by esophageal ulcer in 5.9%, achalasia in 5%, corrosive stricture in 4.5%, and peptic stricture in 3.6%. Conclusion Dysphagia has diverse etiology, and a majority can be diagnosed by endoscopy and barium swallow. Malignancy is an important cause of dysphagia in elderly. Esophageal squamous cell carcinoma remains the most common malignancy, but the incidence of gastroesophageal junctional adenocarcinoma is increasing.

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Different time trend and management of esophagogastric junction adenocarcinoma in three Asian countries

Cited by 37 publications

References 70 publications

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

Association of Helicobacter pylori and gastric atrophy with adenocarcinoma of the esophagogastric junction in Taixing, China

Clinical profile of patients presenting with dysphagia ‐ an experience from a tertiary care center in North India

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