J Gastric Cancer.  2019 Jun;19(2):148-156. 10.5230/jgc.2019.19.e19.

Multimodal Treatment Strategies in Esophagogastric Junction Cancer: a Western Perspective

Affiliations
  • 1Institute of Clinical Cancer Research, Krankenhaus Nordwest, UCT University Cancer Center, Frankfurt am Main, Germany. Goetze.Thorsten@khnw.de
  • 2Department of Surgery, Division of Gastrointestinal Surgery, Seoul National University Hospital, Seoul, Korea.
  • 3Center of Esophageal and Gastric Surgery, Agaplesion Markus Hospital, Frankfurt, Germany.

Abstract

Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.

Keyword

Surgery; Multidisciplinary research; Basic research; Guideline

MeSH Terms

Combined Modality Therapy*
Drug Therapy
Esophageal Neoplasms
Esophagogastric Junction*
Humans
Incidence
Trastuzumab
Trastuzumab

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