Korean J Helicobacter Up Gastrointest Res.  2012 Sep;12(3):151-157. 10.7704/kjhugr.2012.12.3.151.

Treatment of Adenocarcinoma of the Esophagogastric Junction

• Kim SY
• Kim KO

• KMID: 1716075
• DOI: http://doi.org/10.7704/kjhugr.2012.12.3.151

Abstract

In recent years, the incidence of adenocarcinoma of the esophagogastric junction (AEJ) is increasing in the western world, despite of decreasing trend of distal gastric cancer, and the prognosis of AEJ remains poor. The appropriate classification of AEJ is important for selecting the optimal surgical approach and making better prognosis. According to Siewert's classification, distal esophageal cancers (type I) are distinguished from true cardia cancers (type II) and subcardiac gastric cancers (type III). Until now, surgical resection with lymphadenectomy based on Siewert's classification has been the mainstay of treatment for all resectable AEJ. Except surgical approach, therapy strategies for AEJ include endoscopic ablation or endoscopic mucosal resection, endoscopic submucosal dissection, neoadjuvant or adjuvant therapy in combination with surgery, and palliative procedures such as stent, laser, photodynamic therapy. A multidisciplinary approach is necessary for optimal management of AEJ. In this article, we review the treatment options for AEJ including a tailored surgical approach.

Keyword

Adenocarcinoma of the esophagogastric junction; Surgery; Drug therapy; Radiotherapy; Endoscopic therapy

MeSH Terms

Adenocarcinoma
Cardia
Esophageal Neoplasms
Esophagogastric Junction
Incidence
Lymph Node Excision
Photochemotherapy
Prognosis
Stents
Stomach Neoplasms
Western World