Skip to main content

Clinical Classification Systems of Adenocarcinoma of the Esophagogastric Junction

  • Chapter
  • First Online:
Adenocarcinoma of the Esophagogastric Junction

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 182))

Abstract

The classification and definition of adenocarcinomas of the esophagogastric junction (EGJ) have not been standardized, and the choice of surgical procedures is still the subject of controversy. In contrast to the decreasing frequency of gastric cancer and squamous cell carcinomas of the esophagus, a number of studies from various western industrialized nations have reported an increased incidence of adenocarcinomas of the esophagus and cardia in the last 30 years. Studies from population-based cancer registries in the United States, the United Kingdom, and Switzerland have indicated a rapid increase in the incidence of adenocarcinoma of the EGJ (Devesa et al. 1998; Bollschweiler et al. 2001, 2002; Sharma et al. 2003). The reasons for this increase remain unclear; however, a number of causes are being discussed, such as the malignant potential of Barrett mucosa and etiologic factors, such as obesity, dietary factors, alcohol, pharmaceutical agents, and tobacco (Bollschweiler et al. 2001).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aikou T, Shimazu H (1989) Difference in main lymphatic pathways from the lower esophagus and gastric cardia. Jpn J Surg 19:290–295

    Article  PubMed  CAS  Google Scholar 

  • Akiyama H, Tsurumaru M, Kawamura T, Ono Y (1981) Principles of surgical treatment for carcinoma of the esophagus: analysis of lymph node involvement. Ann Surg 194:438–446

    Article  PubMed  CAS  Google Scholar 

  • Altorki K, Skinner DB (1997) Occult cervical nodal metastasis in esophageal cancer: preliminary results of three field lymphadenectomy. J Thorac Cardiovasc Surg 113:540–544

    Article  PubMed  CAS  Google Scholar 

  • American Joint Commmittee on Cancer (2002) Cancer staging manual, 6th edn. Springer, New York

    Google Scholar 

  • Bollschweiler E, Wolfgarten E, Gutschow C, Hölscher AH (2001) Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer 92:549–555

    Article  PubMed  CAS  Google Scholar 

  • Bollschweiler E, Wolfgarten E, Nowroth T, Rosendahl U, Mönig SP, Hölscher AH (2002) Vitamin intake and risk of subtypes of esophageal cancer in Germany. J Cancer Res Clin Oncol 128:575–580

    Article  PubMed  CAS  Google Scholar 

  • Bombeck CT, Dillard DH, Nyhus LM (1966) Muscular anatomy of the gastroesophageal junction and role of phrenoesophageal ligament: autopsy study of sphincter mechanism. Ann Surg 164:643–654

    Article  PubMed  CAS  Google Scholar 

  • Cense HA, Sloof GW, Jlaase JM, Bergman JJ, van Hemert FJ, Fockens P, van Lanschot JJ (2004) Lymphatic drainage routes of the gastric cardia visualized by lymphoscintigraphy. J Nucl Med 45:247–252

    PubMed  Google Scholar 

  • Chandrasoma P, Makarewicz K, Wickramasinghe K, Ma Y, Demeester T (2006) A proposal for a new validated histological definition of the gastroesophageal junction. Hum Pathol 37:40–47

    Article  PubMed  Google Scholar 

  • Chandrasoma P, Wickramasinghe K, Ma Y, DeMeester T (2007) Adenocarcinomas of the distal esophagus and “gastric cardia” are predominantly esophageal carcinomas. Am J Surg Pathol 31:569–575

    Article  PubMed  Google Scholar 

  • Devesa SS, Blot WJ, Fraumeni JF Jr (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83:2049–2053

    Article  PubMed  CAS  Google Scholar 

  • Dolan K, Sutton R, Walker SJ, Morris AL, Campbell F, Williams EMI (1999) New classification of oesophageal and gastric carcinomas derived from changing patterns in epidemiology. Br J Cancer 80:834–842

    Article  PubMed  CAS  Google Scholar 

  • Dresner SM, Lamb PJ, Bennett MK, Hayes N, Griffin SM (2001) The pattern of metastatic lymph node dissemination from adenocarcinoma of the esophagogastric junction. Surgery 129:103–109

    Article  PubMed  CAS  Google Scholar 

  • Ectors N, Driessen A, de Hertog G, Lerut T, Geboes K (2005) Is adenocarcinoma of the esophgo­gastric junction or cardia different from Barrett adenocarcinoma? Arch Pathol Lab Med 128:183–185

    Google Scholar 

  • Ellis FH (1980) Esophagogastrectomy for carcinoma technical considerations based on anatomic location of the lesion. Surg Clin North Am 60:265–279

    PubMed  Google Scholar 

  • Ellis FH, Maggs PR (1981) Surgery for carcinoma of the lower esophagus and cardia. World J Surg 5:527–533

    Article  PubMed  Google Scholar 

  • Ellis FH, Gibb SP, Watkins E (1988) Limited esophagogastrectomy for carcinoma of the cardia: indications, technique and results. Ann Surg 208:354–360

    Article  PubMed  Google Scholar 

  • Griffin SM, Chung SC, Woods SD, Li AK (1990) Adenocarcinoma of the cardia: treatment by thoracoabdominal R3 radical gastrectomy. Br J Surg 77:937–939

    Article  PubMed  CAS  Google Scholar 

  • Hölscher AH, Bollschweiler E, Siewert JR (1995) Carcinoma of the gastric cardia. Ann Chir Gynaecol 84:185–192

    PubMed  Google Scholar 

  • Hölscher AH (2008), Adenocarcinoma of the cardia. In: Patterson A, Pearson G, Cooper JD, Reslauriers J, Rice TW, Luketich JD, Lerut A (eds) Pearsons’ esophageal surgery, 3rd edn. Churchill Livingstone, Elsevier, Philadelphia

    Google Scholar 

  • Hulscher JB, van Sandick JW, de Boer AG, Wijnhoven BP, Tijssen JG, Fockens P, Stalmeier PF, ten Kate FJ, van Dekken H, Obertop H, Tilanus HW, van Lanschot JJ (2002) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347:1662–1669

    Article  PubMed  Google Scholar 

  • Hulscher JB, van Landschot JJ (2005) Individualized surgical treatment of patients with an adenocarcinoma of the distal esophagus or gastro-­esophageal junction. Dig Surg 22:130–134

    Article  PubMed  CAS  Google Scholar 

  • Lerut T (1998) Esophageal surgery at the end of the millennium. J Thorac Cardiovasc Surg 116:1–20

    Article  PubMed  CAS  Google Scholar 

  • Lerut T, Nafteux P, Moons J, Coosemans W, Decker G, de Leyn P, van Raemdonck D, Ectors N (2004) Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome. Ann Surg 240:962–974

    Article  PubMed  CAS  Google Scholar 

  • Marsman WA, Tytgat GN, ten Kate FJ, van Lanschot JJ (2005) Differences and similarities of adenocarcinomas of the esophagus and esophagogastric junction. J Surg Oncol 92:160–168

    Article  PubMed  CAS  Google Scholar 

  • Misumi A, Murakami A, Harada K, Baba K, Akagi M (1989) Definition of carcinoma of the gastric cardia. Langenbecks Arch Chir 374:221–226

    Article  PubMed  CAS  Google Scholar 

  • McClave SA, Boyce HW Jr, Gottfried MR (1987) Early diagnosis of columnar-lined esophagus: a new endoscopic diagnostic criterion. Gastrointest Endosc 33:413–416

    Article  PubMed  CAS  Google Scholar 

  • Mönig SP, Baldus SE, Zirbes TK, Collet PH, Schröder W, Schneider PM, Dienes HP, Hölscher AH (2002) Topographical distribution of lymph node metastasis in adenocarcinoma of the gastroesophageal junction. Hepato-Gastroenterology 49:419–422

    PubMed  Google Scholar 

  • Nakamura T, Ide H, Eguchi R, Ota M, Shimizu S, Isono K (2002) Adenocarcinoma of the esophagogastric junction: a summary of responses to a questionnaire on adenocarcinoma of the esophagus and the esophagogastric junction in Japan. Dis Esophagus 15:219–225

    Article  PubMed  CAS  Google Scholar 

  • Nishi M, Kajisa T, Aiko T, Kaneko Y, Kawaji T et al (1973) The proposal of carcinoma of gastric cardia. Gekarinshou 15:1328–1338

    Google Scholar 

  • Ogawa M, Inui T, Shimoda T et al (2001) Pathology of the gastroesophageal junction in Japanese. Stomach Intestine 36:625–633

    Google Scholar 

  • Omloo JM, Lagarde SM, Hulscher JB, Reitsma JB, Fockens P, van Dekken H, Ten Kate FJ, Obertop H, Tilanus HW, van Lanschot JJ (2007) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg 246:992–1000

    Article  PubMed  Google Scholar 

  • Percy C, Holten VV, Muir C (1990) ICD-O, 2nd edn. WHO, Geneva

    Google Scholar 

  • Sasako M, Sano T, Yamamoto S, Sairenji M, Arai K, Kinoshita T, Nashimoto A, Hiratsuka M; Japan Clinical Oncology Group (JCOG9502) (2006) Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol 7:644–651

    Google Scholar 

  • Sarbia M, Donner A, Gabbert HE (2002)Histopathology of the gastroesophageal junction: a study on 36 operation specimens. Am J Surg Pathol 26:1207–1212

    Google Scholar 

  • Sauvanet A, Mariette C, Thomas P et al (2005) Mortalità and morbidity after resection for adenocarcinoma of the gastroesophageal junction: predicitve factors. J Am Coll Surg 201:253–262

    Article  PubMed  Google Scholar 

  • Sharma R, Samantaray S, Shukla NK, Ralhan R (2003) Transcriptional gene expression profile of human esophageal squamous cell carcinoma. Genomics 81:481–488

    Article  PubMed  CAS  Google Scholar 

  • Siewert JR, Hölscher AH, Becker K, Gössner W (1987) Kardiakarzinom: Versuch einer thera­peutisch relevanten Klassifikation. Chirurg 58:25–32

    PubMed  CAS  Google Scholar 

  • Siewert JR, Feith M, Werner M, Stein HJ (2000) Adenocarcinoma of the esophagogastric junction. Ann Surg 232:353–361

    Article  Google Scholar 

  • Siewert JR, Feith M, Stein HJ (2005) Biologic and clinical variations of adenocarcinoma at the esophago-gastric junction. Relevance of a topographic-anatomic subclassification. J Surg Oncol 13:139–146

    Article  Google Scholar 

  • Siewert JR, Stein HJ (1998) Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg 85:1457–1459

    Article  PubMed  CAS  Google Scholar 

  • Sobin LH, Wittekind C (eds) (2002) International Union against cancer. TNM classification of malignant tumors. Wiley, New York

    Google Scholar 

  • Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) International Union against cancer. TNM classification of malignant tumours. John Wiley& Sons, New York

    Google Scholar 

  • Tachimori Y, Kato H, Watanabe H, Sasako M, Kinoshita T, Maruyama K (1996) Difference between carcinoma of the lower esophagus and the cardia. World J Surg 20:507–510

    Article  PubMed  CAS  Google Scholar 

  • Takubo K, Sawabe M, Esaki Y (1995) Pathology of the esophagogastric junction. Dig Endosc 7:479–488

    Google Scholar 

  • Wang LS, Wu CW, Hsieh MJ, Fahn HJ, Huang MH, Chien KY (1993) Lymph node metastasis in patients with adenocarcinoma of gastric cardia. Cancer 71:1948–1953

    Google Scholar 

  • von Rahden BH, Stein HJ, Feith M, Becker K, Siewert JR (2005) Lymphatic vessel invasion as a prognostic factor in patients with primary resected adenocarcinomas of the esophagogastric junction. J Clin Oncol 23:874–879

    Google Scholar 

  • Yuasa N, Miyake H, Yamada T, Ebata T, Nimura Y, Hattori T (2006) Clinicopathologic comparison of Siewert type II and III adenocarcinomas of the gastroesophageal junction. World J Surg 30: 364–371

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stefan Paul Mönig .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Mönig, S.P., Hölscher, A.H. (2009). Clinical Classification Systems of Adenocarcinoma of the Esophagogastric Junction. In: Schneider, P. (eds) Adenocarcinoma of the Esophagogastric Junction. Recent Results in Cancer Research, vol 182. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-70579-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-70579-6_2

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-70578-9

  • Online ISBN: 978-3-540-70579-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics