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Esophagogastric Junction (EGJ) Carcinoma: An Updated Review

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GI Surgery Annual

Part of the book series: GI Surgery Annual ((GISA,volume 25))

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Abstract

Epithelial carcinomas constitute the majority of all cases of esophageal cancer. While squamous cell carcinoma (SCC) typically occurs throughout the esophagus (commonest middle third), adenocarcinomas mostly occur in the distal one-third and the esophagogastric junction (EGJ). All adenocarcinomas involving the EGJ are included under the group of EGJ carcinomas; these include esophageal carcinomas, gastric carcinomas and true carcinomas of the cardia. It is rare for lower esophageal SCCs to involve the EGJ; hence all discussion of EGJ carcinomas refers to adenocarcinoma. The incidence of adenocarcinoma has increased, while that of SCC has declined steadily in the Western population, in the last few decades [1, 2]. Hence EGJ carcinoma has become a tumour of increasing importance over the last few decades. The reasons for the increasing focus on these tumours include the rising incidence in the Western world, the controversies in classifications, the generally poor prognosis and major differences in the treatment and outcomes as compared to squamous cell carcinoma of the esophagus.

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References

  1. Haverkamp L, Seesing MF, Ruurda JP, Boone J, Hillegersberg R v. Worldwide trends in surgical techniques in the treatment of esophageal and gastroesophageal junction cancer. Dis Esophagus. 2017;30:1–7.

    CAS  PubMed  Google Scholar 

  2. Wong MCS, et al. Global Incidence and mortality of oesophageal cancer and their correlation with socioeconomic indicators temporal patterns and trends in 41 countries. Sci Rep. 2018;8:4522.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Runge TM, Abrams JA, Shaheen NJ. Epidemiology of Barrett’s esophagus and esophageal adenocarcinoma. Gastroenterol Clin N Am. 2015;44:203–31.

    Article  Google Scholar 

  4. Siewert JR, Stein HJ. Classification of adenocarcinoma of the oesophagogastric junction. Br J Surg. 1998;85:1457–9.

    Article  CAS  PubMed  Google Scholar 

  5. Stein JR, Stein HJ. Carcinoma of the gastroesophageal junction - classification, pathology and extent of resection. Dis Esophagus. 1996;9:173–82.

    Google Scholar 

  6. Monig SP, Holscher AH. Clinical classification systems of adenocarcinoma of the esophagogastric junction. Recent Results Cancer Res. 2010;182:19–28.

    Article  PubMed  Google Scholar 

  7. Aikou T, Shimazu H. Difference in main lymphatic pathways from the lower esophagus and gastric cardia. Jpn J Surg. 1989;19:290–5.

    Article  CAS  PubMed  Google Scholar 

  8. Curtis NJ, et al. The relevance of the Siewert classification in the era of multimodal therapy for adenocarcinoma of the gastro-oesophageal junction. J Surg Oncol. 2014;109:202–7.

    Article  PubMed  Google Scholar 

  9. Grotenhuis BA, et al. Preoperative assessment of tumour location and station-specific lymph node status in patients with adenocarcinoma of the gastroesophageal junction. World J Surg. 2013;37:147–55.

    Article  PubMed  Google Scholar 

  10. Pedrazzani C, et al. Evaluation of Siewert classification in gastro-esophageal junction adenocarcinoma: what is the role of endoscopic ultrasonography? J Surg Oncol. 2005;91:226–31.

    Article  PubMed  Google Scholar 

  11. Omloo JM, et al. 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. 2007;246:992–1000; discussion 1000-1001.

    Article  PubMed  Google Scholar 

  12. Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol. 2010;17:1721–4.

    Article  PubMed  Google Scholar 

  13. Rice TW, et al. Esophagus and esophagogastric junction. In:AJCC Cancer Staging Manual. New York: Springer; 2017. p. 185–202.

    Chapter  Google Scholar 

  14. Ferlay J, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–86.

    Article  CAS  PubMed  Google Scholar 

  15. Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64:381–7.

    Article  PubMed  Google Scholar 

  16. Du X, Hidayat K, Shi BM. Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep. 2017;37:BSR20160474.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–31.

    Article  CAS  PubMed  Google Scholar 

  18. Marsman WA, Tytgat GN, ten Kate FJ, van Lanschot JJ. Differences and similarities of adenocarcinomas of the esophagus and esophagogastric junction. J Surg Oncol. 2005;92:160–8.

    Article  CAS  PubMed  Google Scholar 

  19. Falk J, Carstens H, Lundell L, Albertsson M. Incidence of carcinoma of the oesophagus and gastric cardia. Changes over time and geographical differences. Acta Oncol. 2007;46:1070–4.

    Article  PubMed  Google Scholar 

  20. Buas MF, Vaughan TL. Epidemiology and risk factors for gastroesophageal junction tumours: understanding the rising incidence of this disease. Semin Radiat Oncol. 2013;23:3–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wang L-D. Primary adenocarcinomas of lower esophagus, esophagogastric junction and gastric cardia: in special reference to China. World J Gastroenterol. 2003;9:1156.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Islami F, et al. Epidemiologic features of upper gastrointestinal tract cancers in Northeastern Iran. Br J Cancer. 2004;90:1402–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Kubo A, Corley DA. Marked multi-ethnic variation of esophageal and gastric cardia carcinomas within the United States. Am J Gastroenterol. 2004;99:582–8.

    Article  PubMed  Google Scholar 

  24. Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategies. Gastric Cancer. 2010;13:63–73.

    Article  PubMed  Google Scholar 

  25. Shaheen NJ, Falk GW, Iyer PG, Gerson LB, American College of Gastroenterology. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2016;111:30–50; quiz 51.

    Article  CAS  PubMed  Google Scholar 

  26. Wang KK, Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol. 2008;103:788.

    Article  PubMed  Google Scholar 

  27. Drahos J, et al. Age-specific risk factor profiles of adenocarcinomas of the esophagus: a pooled analysis from the international BEACON consortium. Int J Cancer. 2016;138:55–64.

    Article  CAS  PubMed  Google Scholar 

  28. Kelty C. Columnar-lined esophagus without intestinal metaplasia should not be dismissed as having no cancer risk. Am J Gastroenterol. 2008;103:3205.

    PubMed  Google Scholar 

  29. Sharma P, et al. Dysplasia and cancer in a large multicenter cohort of patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:566–72.

    Article  PubMed  Google Scholar 

  30. Vaughan TL, Fitzgerald RC. Precision prevention of oesophageal adenocarcinoma. Nat Rev Gastroenterol Hepatol. 2015;12:243–8.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Siewert JR, Feith M, Stein HJ. Biologic and clinical variations of adenocarcinoma at the esophago-gastric junction: relevance of a topographic-anatomic subclassification. J Surg Oncol. 2005;90:139–146; discussion 146.

    Article  PubMed  Google Scholar 

  32. Thrift AP, et al. Obesity and risk of esophageal adenocarcinoma and Barrett’s esophagus: a Mendelian randomization study. J Natl Cancer Inst. 2014;106:dju252.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Chow WH, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90:150–5.

    Article  CAS  PubMed  Google Scholar 

  34. Wu AH, Tseng CC, Bernstein L. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer. 2003;98:940–8.

    Article  PubMed  Google Scholar 

  35. Parsonnet J, Friedman GD, Orentreich N, Vogelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut. 1997;40:297–301.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Nie S, Chen T, Yang X, Huai P, Lu M. Association of Helicobacter pylori infection with esophageal adenocarcinoma and squamous cell carcinoma: a meta-analysis. Dis Esophagus. 2014;27:645–53.

    Article  CAS  PubMed  Google Scholar 

  37. The EUROGAST Study Group. An international association between Helicobacter pylori infection and gastric cancer. Lancet. 1993;341:1359–63.

    Article  Google Scholar 

  38. Cook MB, et al. Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: a pooled analysis from the international BEACON consortium. J Natl Cancer Inst. 2010;102:1344–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Gammon MD, et al. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1997;89:1277–84.

    Article  CAS  PubMed  Google Scholar 

  40. Freedman ND, et al. Alcohol intake and risk of oesophageal adenocarcinoma: a pooled analysis from the BEACON consortium. Gut. 2011;60:1029–37.

    Article  PubMed  Google Scholar 

  41. World Cancer Research Fund/American Institute for Cancer Research, Continuous update project expert report. Diet, nutrition, physical activity and oesophageal cancer, vol. 2018; 2018.

    Google Scholar 

  42. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014;513:202–9.

    Article  CAS  Google Scholar 

  43. Cancer Genome Atlas Research Network, et al. Integrated genomic characterization of oesophageal carcinoma. Nature. 2017;541:169–75.

    Article  CAS  Google Scholar 

  44. DaVee T, Ajani JA, Lee JH. Is endoscopic ultrasound examination necessary in the management of esophageal cancer? World J Gastroenterol. 2017;23:751–62.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Worrell SG, Oh DS, Greene CL, Demeester SR, Hagen JA. Endoscopic ultrasound staging of stenotic esophageal cancers may be unnecessary to determine the need for neoadjuvant therapy. J Gastrointest Surg. 2014;18:318–20.

    Article  PubMed  Google Scholar 

  46. Dhupar R, et al. Endoscopic ultrasound estimates for tumour depth at the gastroesophageal junction are inaccurate: implications for the liberal use of endoscopic resection. Ann Thorac Surg. 2015;100:1812–6.

    Article  PubMed  Google Scholar 

  47. Qumseya BJ, et al. Diagnostic performance of EUS in predicting advanced cancer among patients with Barrett’s esophagus and high-grade dysplasia/early adenocarcinoma: systematic review and meta-analysis. Gastrointest Endosc. 2015;81:865–74.e862.

    Article  PubMed  Google Scholar 

  48. Thosani N, et al. Diagnostic accuracy of EUS in differentiating mucosal versus submucosal invasion of superficial esophageal cancers: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75:242–53.

    Article  PubMed  Google Scholar 

  49. Puli SR, et al. Staging accuracy of esophageal cancer by endoscopic ultrasound: a meta-analysis and systematic review. World J Gastroenterol. 2008;14:1479–90.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Puli SR, et al. Endoscopic ultrasound: it’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review. World J Gastroenterol. 2008;14:3028.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Marsman WA, et al. Potential impact of EUS-FNA staging of proximal lymph nodes in patients with distal esophageal carcinoma. Endoscopy. 2006;38:825–9.

    Article  CAS  PubMed  Google Scholar 

  52. Luu C, et al. Endoscopic ultrasound staging for early esophageal cancer: are we denying patients neoadjuvant chemo-radiation? World J Gastroenterol. 2017;23:8193–9.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Halvorsen RA, Thompson WA. Computed tomography of the gastroesophageal junction. Crit Rev Diagn Imaging. 1984;21:183–228.

    CAS  PubMed  Google Scholar 

  54. Picus D, Balfe DM, Koehler RE, Roper CL, Owen JW. Computed tomography in the staging of esophageal carcinoma. Radiology. 1983;146:433–8.

    Article  CAS  PubMed  Google Scholar 

  55. van Vliet EP, Heijenbrok-Kal MH, Hunink MG, Kuipers EJ, Siersema PD. Staging investigations for oesophageal cancer: a meta-analysis. Br J Cancer. 2008;98:547–57.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Quint LE, Hepburn LM, Francis IR, Whyte RI, Orringer MB. Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer. 1995;76:1120–5.

    Article  CAS  PubMed  Google Scholar 

  57. Erasmus JJ, Munden RF. The role of integrated computed tomography positron-emission tomography in esophageal cancer: staging and assessment of therapeutic response. Semin Radiat Oncol. 2007;17:29–37.

    Article  PubMed  Google Scholar 

  58. Ott K, Herrmann K, Krause BJ, Lordick F. The value of PET imaging in patients with localized gastroesophageal cancer. Gastrointest Cancer Res. 2008;2:287–94.

    PubMed  PubMed Central  Google Scholar 

  59. Purandare NC, et al. Incremental value of 18F-FDG PET/CT in therapeutic decision-making of potentially curable esophageal adenocarcinoma. Nucl Med Commun. 2014;35:864–9.

    PubMed  Google Scholar 

  60. Lin J, et al. State-of-the-art molecular imaging in esophageal cancer management: implications for diagnosis, prognosis, and treatment. J Gastrointest Oncol. 2015;6:3–19.

    PubMed  PubMed Central  Google Scholar 

  61. Sihvo EI, et al. Adenocarcinoma of the esophagus and the esophagogastric junction: positron emission tomography improves staging and prediction of survival in distant but not in locoregional disease. J Gastrointest Surg. 2004;8:988–96.

    Article  PubMed  Google Scholar 

  62. Lowe VJ, et al. Comparison of positron emission tomography, computed tomography, and endoscopic ultrasound in the initial staging of patients with esophageal cancer. Mol Imaging Biol. 2005;7:422–30.

    Article  PubMed  Google Scholar 

  63. Lordick F, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase II trial. Lancet Oncol. 2007;8:797–805.

    Article  PubMed  Google Scholar 

  64. zum Buschenfelde CM, et al. (18)F-FDG PET-guided salvage neoadjuvant radiochemotherapy of adenocarcinoma of the esophagogastric junction: the MUNICON II trial. J Nucl Med. 2011;52:1189–96.

    Article  PubMed  Google Scholar 

  65. Schollaert P, et al. A systematic review of the predictive value of (18)FDG-PET in esophageal and esophagogastric junction cancer after neoadjuvant chemoradiation on the survival outcome stratification. J Gastrointest Surg. 2014;18:894–905.

    Article  PubMed  Google Scholar 

  66. Kim TJ, Kim HY, Lee KW, Kim MS. Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy. Radiographics. 2009;29:403–21.

    Article  PubMed  Google Scholar 

  67. Vosmik M. Technological advances in radiotherapy for esophageal cancer. World J Gastroenterol. 2010;16:5555.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Wang Z, Chen JQ. Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic review. BMC Gastroenterol. 2011;11:19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Lim J, et al. Comparison of CT and 18F-FDG PET for detecting peritoneal metastasis on the preoperative evaluation for gastric carcinoma. Korean J Radiol. 2006;7:249.

    Article  PubMed  PubMed Central  Google Scholar 

  70. de Graaf GW, Ayantunde AA, Parsons SL, Duffy JP, Welch NT. The role of staging laparoscopy in oesophagogastric cancers. Eur J Surg Oncol. 2007;33:988–92.

    Article  PubMed  Google Scholar 

  71. Convie L, et al. The current role of staging laparoscopy in oesophagogastric cancer. Ann R Coll Surg Engl. 2015;97:146–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Nath J, Moorthy K, Taniere P, Hallissey M, Alderson D. Peritoneal lavage cytology in patients with oesophagogastric adenocarcinoma. Br J Surg. 2008;95:721–6.

    Article  CAS  PubMed  Google Scholar 

  73. Ikoma N, et al. Yield of staging laparoscopy and lavage cytology for radiologically occult peritoneal carcinomatosis of gastric cancer. Ann Surg Oncol. 2016;23:4332–7.

    Article  PubMed  Google Scholar 

  74. Simon M, et al. Accuracy of staging laparoscopy in detecting peritoneal dissemination in patients with gastroesophageal adenocarcinoma. Dis Esophagus. 2016;29:236–40.

    Article  CAS  PubMed  Google Scholar 

  75. National Comprehensive Cancer Network, Esophageal and esophagogastric junction cancers guidelines (version 2.2018), vol. 2018; 2018.

    Google Scholar 

  76. Nicholson AG, et al. Eighth edition staging of thoracic malignancies: implications for the reporting pathologist. Arch Pathol Lab Med. 2018;142:645–61.

    Article  PubMed  Google Scholar 

  77. Schlemper RJ, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Stein HJ, von Rahden BH, Feith M. Surgery for early stage esophageal adenocarcinoma. J Surg Oncol. 2005;92:210–7.

    Article  CAS  PubMed  Google Scholar 

  79. Holscher AH, et al. Prognostic impact of upper, middle, and lower third mucosal or submucosal infiltration in early esophageal cancer. Ann Surg. 2011;254:802–7.

    Article  PubMed  Google Scholar 

  80. Pech O, et al. Comparison between endoscopic and surgical resection of mucosal esophageal adenocarcinoma in Barrett’s esophagus at two high-volume centers. Ann Surg. 2011;254:67–72.

    Article  PubMed  Google Scholar 

  81. Newton AD, et al. Surgical management of early-stage esophageal adenocarcinoma based on lymph node metastasis risk. Ann Surg Oncol. 2018;25:318–25.

    Article  PubMed  Google Scholar 

  82. Thota PN, et al. Correlation between endoscopic forceps biopsies and endoscopic mucosal resection with endoscopic ultrasound in patients with Barrett’s esophagus with high-grade dysplasia and early cancer. Surg Endosc. 2017;31:1336–41.

    Article  PubMed  Google Scholar 

  83. Larghi A, et al. EUS followed by EMR for staging of high-grade dysplasia and early cancer in Barrett’s esophagus. Gastrointest Endosc. 2005;62:16–23.

    Article  PubMed  Google Scholar 

  84. Whiteman DC, et al. Australian clinical practice guidelines for the diagnosis and management of Barrett’s esophagus and early esophageal adenocarcinoma. J Gastroenterol Hepatol. 2015;30:804–20.

    Article  PubMed  Google Scholar 

  85. Nentwich MF, et al. Depth of submucosal tumour infiltration and its relevance in lymphatic metastasis formation for T1b squamous cell and adenocarcinomas of the esophagus. J Gastrointest Surg. 2014;18:242–9.

    Article  PubMed  Google Scholar 

  86. Manner H, et al. The frequency of lymph node metastasis in early-stage adenocarcinoma of the esophagus with incipient submucosal invasion (pT1b sm1) depending on histological risk patterns. Surg Endosc. 2015;29:1888–96.

    Article  PubMed  Google Scholar 

  87. Pauthner M, Haist T, Mann M, Lorenz D. Surgical therapy of early carcinoma of the esophagus. Visc Med. 2015;31:326–30.

    Article  Google Scholar 

  88. Buskens CJ, et al. Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc. 2004;60:703–10.

    Article  PubMed  Google Scholar 

  89. Pech O, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57:1200–6.

    Article  CAS  PubMed  Google Scholar 

  90. Shaheen NJ, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–88.

    Article  CAS  PubMed  Google Scholar 

  91. Barret M, Prat F. Diagnosis and treatment of superficial esophageal cancer. Ann Gastroenterol. 2018;31:256–65.

    PubMed  PubMed Central  Google Scholar 

  92. Subramaniam S, et al. Complex early Barrett’s neoplasia at 3 Western centers: European Barrett’s Endoscopic Submucosal Dissection Trial (E-BEST). Gastrointest Endosc. 2017;86:608–18.

    Article  PubMed  Google Scholar 

  93. Pech O, et al. Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology. 2014;146:652–660.e651.

    Article  PubMed  Google Scholar 

  94. Pohl H, Sonnenberg A, Strobel S, Eckardt A, Rosch T. Endoscopic versus surgical therapy for early cancer in Barrett’s esophagus: a decision analysis. Gastrointest Endosc. 2009;70:623–31.

    Article  PubMed  Google Scholar 

  95. Buttar NS, et al. Extent of high-grade dysplasia in Barrett’s esophagus correlates with risk of adenocarcinoma. Gastroenterology. 2001;120:1630–9.

    Article  CAS  PubMed  Google Scholar 

  96. Stein HJ, et al. Early esophageal cancer: pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg. 2005;242:566–75.

    PubMed  PubMed Central  Google Scholar 

  97. May A, et al. Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett’s oesophagus: acute-phase and intermediate results of a new treatment approach. Eur J Gastroenterol Hepatol. 2002;14:1085–91.

    Article  PubMed  Google Scholar 

  98. Buttar NS, Wang KK, Lutzke LS, Krishnadath KK, Anderson MA. Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett’s esophagus. Gastrointest Endosc. 2001;54:682–8.

    CAS  PubMed  Google Scholar 

  99. Hulscher JB, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med. 2002;347:1662–9.

    Article  PubMed  Google Scholar 

  100. Hunt BM, et al. Outcomes in patients who have failed endoscopic therapy for dysplastic Barrett’s metaplasia or early esophageal cancer. Ann Thorac Surg. 2013;95:1734–40.

    Article  PubMed  Google Scholar 

  101. Westerterp M, et al. Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch. 2005;446:497–504.

    Article  PubMed  Google Scholar 

  102. Stein HJ, Feith M, Mueller J, Werner M, Siewert JR. Limited resection for early adenocarcinoma in Barrett’s esophagus. Ann Surg. 2000;232:733–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Zapletal C, et al. Quality of life after surgical treatment of early Barrett’s cancer: a prospective comparison of the Ivor-Lewis resection versus the modified Merendino resection. World J Surg. 2014;38:1444–52.

    Article  PubMed  Google Scholar 

  104. Akiyama H, Tsurumaru M, Kawamura T, Ono Y. Esophageal stripping with preservation of the vagus nerve. Int Surg. 1982;67:125–8.

    CAS  PubMed  Google Scholar 

  105. Peyre CG, et al. Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia. Ann Surg. 2007;246:665–71; discussion 671-664.

    Article  PubMed  Google Scholar 

  106. DeMeester SR. Vagal-sparing esophagectomy: is it a useful addition? Ann Thorac Surg. 2010;89:S2156–8.

    Article  PubMed  Google Scholar 

  107. Marino KA, Sullivan JL, Weksler B. Esophagectomy versus endoscopic resection for patients with early-stage esophageal adenocarcinoma: a National Cancer Database propensity-matched study. J Thorac Cardiovasc Surg. 2018;155:2211–2218.e2211.

    Article  PubMed  Google Scholar 

  108. Medical Research Council Oesophageal Cancer Working Group. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet. 2002;359:1727–33.

    Article  Google Scholar 

  109. Kelsen DP, et al. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25:3719–25.

    Article  PubMed  Google Scholar 

  110. Peracchia A, Bonavina L. Outcome of surgical treatment. In: Perrachia A, Bonavina L, editors. Adenocarcinoma of the esophagogastric junction. Milan: EDRA; 2000. p. 151–69.

    Google Scholar 

  111. Feith M, Stein HJ, Siewert JR. Adenocarcinoma of the esophagogastric junction: surgical therapy based on 1602 consecutive resected patients. Surg Oncol Clin N Am. 2006;15:751–64.

    Article  PubMed  Google Scholar 

  112. Tam PC, Siu KF, Cheung HC, Ma L, Wong J. Local recurrences after subtotal esophagectomy for squamous cell carcinoma. Ann Surg. 1987;205:189–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Khoshnevis J, Moradi A, Azargashb E, Gholizade B, Sobhiyeh MR. A study of contractility of proximal surgical margin in esophageal cancer. Iran J Cancer Prev. 2013;6:25–7.

    PubMed  PubMed Central  Google Scholar 

  114. Siu KF, Cheung HC, Wong J. Shrinkage of the esophagus after resection for carcinoma. Ann Surg. 1986;203:173–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  115. Miller C. Carcinoma of thoracic oesophagus and cardia. A review of 405 cases. Br J Surg. 1962;49:507–22.

    Article  CAS  PubMed  Google Scholar 

  116. Barbour AP, et al. Adenocarcinoma of the gastroesophageal junction: influence of esophageal resection margin and operative approach on outcome. Ann Surg. 2007;246:1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Mariette C, Castel B, Balon JM, Van Seuningen I, Triboulet JP. Extent of oesophageal resection for adenocarcinoma of the oesophagogastric junction. Eur J Surg Oncol. 2003;29:588–93.

    Article  CAS  PubMed  Google Scholar 

  118. Migliore M, Rassl D, Criscione A. Longitudinal and circumferential resection margin in adenocarcinoma of distal esophagus and cardia. Future Oncol. 2014;10:891–901.

    Article  CAS  PubMed  Google Scholar 

  119. Mine S, et al. Proximal margin length with transhiatal gastrectomy for Siewert type II and III adenocarcinomas of the oesophagogastric junction. Br J Surg. 2013;100:1050–4.

    Article  CAS  PubMed  Google Scholar 

  120. Casson AG, Darnton SJ, Subramanian S, Hiller L. What is the optimal distal resection margin for esophageal carcinoma? Ann Thorac Surg. 2000;69:205–9.

    Article  CAS  PubMed  Google Scholar 

  121. Ito H, et al. Adenocarcinoma of the gastric cardia: what is the optimal surgical approach? J Am Coll Surg. 2004;199:880–6.

    Article  PubMed  Google Scholar 

  122. Moehler M, et al. International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus. Gastric Cancer. 2015;18:550–63.

    Article  PubMed  Google Scholar 

  123. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1–19.

    Article  Google Scholar 

  124. Postlewait LM, Maithel SK. The importance of surgical margins in gastric cancer. J Surg Oncol. 2016;113:277–82.

    Article  PubMed  Google Scholar 

  125. Raziee HR, et al. Systematic review of the predictors of positive margins in gastric cancer surgery and the effect on survival. Gastric Cancer. 2012;15(Suppl 1):S116–24.

    Article  PubMed  Google Scholar 

  126. Dikken JL, et al. Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastric cancer. J Clin Oncol. 2010;28:2430–6.

    Article  PubMed  Google Scholar 

  127. Bickenbach KA, Gonen M, Strong V, Brennan MF, Coit DG. Association of positive transection margins with gastric cancer survival and local recurrence. Ann Surg Oncol. 2013;20:2663–8.

    Article  CAS  PubMed  Google Scholar 

  128. Sagar PM, Johnston D, McMahon MJ, Dixon MF, Quirke P. Significance of circumferential resection margin involvement after oesophagectomy for cancer. Br J Surg. 1993;80:1386–8.

    Article  CAS  PubMed  Google Scholar 

  129. Wu J, Chen QX, Teng LS, Krasna MJ. Prognostic significance of positive circumferential resection margin in esophageal cancer: a systematic review and meta-analysis. Ann Thorac Surg. 2014;97:446–53.

    Article  PubMed  Google Scholar 

  130. Chan DS, Reid TD, Howell I, Lewis WG. Systematic review and meta-analysis of the influence of circumferential resection margin involvement on survival in patients with operable oesophageal cancer. Br J Surg. 2013;100:456–64.

    Article  CAS  PubMed  Google Scholar 

  131. O’Neill JR, et al. Defining a positive circumferential resection margin in oesophageal cancer and its implications for adjuvant treatment. Br J Surg. 2013;100:1055–63.

    Google Scholar 

  132. Griffiths EA, Brummell Z, Gorthi G, Pritchard SA, Welch IM. The prognostic value of circumferential resection margin involvement in oesophageal malignancy. Eur J Surg Oncol. 2006;32:413–9.

    Article  CAS  PubMed  Google Scholar 

  133. Altorki N, Skinner D. Should en bloc esophagectomy be the standard of care for esophageal carcinoma? Ann Surg. 2001;234:581–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  134. Mirnezami R, et al. Multivariate analysis of clinicopathological factors influencing survival following esophagectomy for cancer. Int J Surg. 2010;8:58–63.

    Article  PubMed  Google Scholar 

  135. Hulshoff JB, et al. Prognostic value of the circumferential resection margin in esophageal cancer patients after neoadjuvant chemoradiotherapy. Ann Surg Oncol. 2015;22(Suppl 3):S1301–9.

    Article  PubMed  Google Scholar 

  136. Pedrazzani C, et al. Lymph node involvement in advanced gastroesophageal junction adenocarcinoma. J Thorac Cardiovasc Surg. 2007;134:378–85.

    Article  PubMed  Google Scholar 

  137. Okholm C, Svendsen LB, Achiam MP. Status and prognosis of lymph node metastasis in patients with cardia cancer - a systematic review. Surg Oncol. 2014;23:140–6.

    Article  PubMed  Google Scholar 

  138. Dresner SM, Lamb PJ, Bennett MK, Hayes N, Griffin SM. The pattern of metastatic lymph node dissemination from adenocarcinoma of the esophagogastric junction. Surgery. 2001;129:103–9.

    Article  CAS  PubMed  Google Scholar 

  139. Lagarde SM, et al. Prospective analysis of patients with adenocarcinoma of the gastric cardia and lymph node metastasis in the proximal field of the chest. Br J Surg. 2005;92:1404–8.

    Article  CAS  PubMed  Google Scholar 

  140. Altorki N, Kent M, Ferrara C, Port J. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg. 2002;236:177–83.

    Article  PubMed  PubMed Central  Google Scholar 

  141. van de Ven C, De Leyn P, Coosemans W, Van Raemdonck D, Lerut T. Three-field lymphadenectomy and pattern of lymph node spread in T3 adenocarcinoma of the distal esophagus and the gastro-esophageal junction. Eur J Cardiothorac Surg. 1999;15:769–73.

    Article  PubMed  Google Scholar 

  142. Rice TW, Patil DT, Blackstone EH. 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg. 2017;6:119–30.

    Article  PubMed  PubMed Central  Google Scholar 

  143. Anderegg MC, et al. Prognostic significance of the location of lymph node metastases in patients with adenocarcinoma of the distal esophagus or gastroesophageal junction. Ann Surg. 2016;264:847–53.

    Article  PubMed  Google Scholar 

  144. Sepesi B, et al. Survival in patients with esophageal adenocarcinoma undergoing trimodality therapy is independent of regional lymph node location. Ann Thorac Surg. 2016;101:1075–80.

    Article  PubMed  Google Scholar 

  145. Peyre CG, et al. Predicting systemic disease in patients with esophageal cancer after esophagectomy: a multinational study on the significance of the number of involved lymph nodes. Ann Surg. 2008;248:979–85.

    Article  PubMed  Google Scholar 

  146. Sharma S, Fujita H, Yamana H, Kakegawa T. Patterns of lymph node metastasis in 3-field dissection for carcinoma in the thoracic esophagus. Surg Today. 1994;24:410–4.

    Article  CAS  PubMed  Google Scholar 

  147. Kitagawa Y, et al. Intraoperative lymphatic mapping and sentinel lymph node sampling in esophageal and gastric cancer. Surg Oncol Clin N Am. 2002;11:293–304.

    Article  PubMed  Google Scholar 

  148. Netherlands Trial Register, Sentinel node navigation surgery in early esophageal adenocarcinoma patients: the SNAP study, vol. 2018; 2015.

    Google Scholar 

  149. Yan R, Dang C. Meta-analysis of Transhiatal Esophagectomy in carcinoma of esophagogastric junction, does it have an advantage? Int J Surg. 2017;42:183–90.

    Article  PubMed  Google Scholar 

  150. Aurello P, et al. Transthoracically or transabdominally: how to approach adenocarcinoma of the distal esophagus and cardia. A meta-analysis. Tumori. 2016;102:352–60.

    Article  PubMed  Google Scholar 

  151. Wei MT, et al. Transthoracic vs transhiatal surgery for cancer of the esophagogastric junction: a meta-analysis. World J Gastroenterol. 2014;20:10183–92.

    Article  PubMed  PubMed Central  Google Scholar 

  152. Zheng Z, et al. Transthoracic versus abdominal-transhiatal resection for treating Siewert type II/III adenocarcinoma of the esophagogastric junction: a meta-analysis. Int J Clin Exp Med. 2015;8:17167–82.

    PubMed  PubMed Central  Google Scholar 

  153. Donohoe CL, O’Farrell NJ, Ravi N, Reynolds JV. Evidence-based selective application of transhiatal esophagectomy in a high-volume esophageal center. World J Surg. 2012;36:98–103.

    Google Scholar 

  154. Allum WH, et al. Guidelines for the management of oesophageal and gastric cancer. Gut. 2011;60:1449–72.

    Article  CAS  PubMed  Google Scholar 

  155. Peyre CG, et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg. 2008;248:549–56.

    Article  PubMed  Google Scholar 

  156. Rizk NP, et al. Optimum lymphadenectomy for esophageal cancer. Ann Surg. 2010;251:46–50.

    Article  PubMed  Google Scholar 

  157. Bumm R, Wong J. More or less surgery for esophageal cancer: extent of lymphadenectomy in esophagectomy for squamous cell esophageal carcinoma: how much is necessary? Dis Esophagus. 1995;8:78.

    Google Scholar 

  158. DeMeester TR, Barlow AP. Surgery and current management for cancer of the esophagus and cardia: part I. Curr Probl Surg. 1988;25:481–531.

    Article  Google Scholar 

  159. DeMeester TR, Barlow AP. Surgery and current management for cancer of the esophagus and cardia: part II. Curr Probl Surg. 1988;25:541–605.

    Article  Google Scholar 

  160. Hulscher JB, et al. Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia. Br J Surg. 2001;88:715–9.

    Article  CAS  PubMed  Google Scholar 

  161. Koen Talsma A, et al. Lymph node retrieval during esophagectomy with and without neoadjuvant chemoradiotherapy: prognostic and therapeutic impact on survival. Ann Surg. 2014;260:786–92.

    Article  CAS  PubMed  Google Scholar 

  162. Mariette C, Piessen G, Briez N, Triboulet JP. The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg. 2008;247:365–71.

    Article  PubMed  Google Scholar 

  163. Lococo F, et al. Time-trend analysis of the pulmonary function after surgical treatment for esophageal cancer. Eur Rev Med Pharmacol Sci. 2014;18:3189–98.

    CAS  PubMed  Google Scholar 

  164. Biere SS, Cuesta MA, van der Peet DL. Minimally invasive versus open esophagectomy for cancer: a systematic review and meta-analysis. Minerva Chir. 2009;64:121–33.

    CAS  PubMed  Google Scholar 

  165. Maas KW, et al. Quality of life and late complications after minimally invasive compared to open esophagectomy: results of a randomized trial. World J Surg. 2015;39:1986–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  166. Hansen S, et al. Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status. Gut. 2007;56:918–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  167. Derakhshan MH, et al. Combination of gastric atrophy, reflux symptoms and histological subtype indicates two distinct aetiologies of gastric cardia cancer. Gut. 2008;57:298–305.

    Article  CAS  PubMed  Google Scholar 

  168. McColl KE, Going JJ. Aetiology and classification of adenocarcinoma of the gastro-oesophageal junction/cardia. Gut. 2010;59:282–4.

    Article  PubMed  Google Scholar 

  169. Zhang H, et al. Adenocarcinomas of the esophagogastric junction: experiences at a single institution in China. World J Surg Oncol. 2013;11:155.

    Article  PubMed  PubMed Central  Google Scholar 

  170. Suh YS, et al. Should adenocarcinoma of the esophagogastric junction be classified as esophageal cancer? A comparative analysis according to the seventh AJCC TNM classification. Ann Surg. 2012;255:908–15.

    Article  PubMed  Google Scholar 

  171. Graham AJ, Finley RJ, Clifton JC, Evans KG, Fradet G. Surgical management of adenocarcinoma of the cardia. Am J Surg. 1998;175:418–21.

    Article  CAS  PubMed  Google Scholar 

  172. Sauvanet A, et al. Mortality and morbidity after resection for adenocarcinoma of the gastroesophageal junction: predictive factors. J Am Coll Surg. 2005;201:253–62.

    Article  PubMed  Google Scholar 

  173. Leers JM, et al. Clinical characteristics, biologic behavior, and survival after esophagectomy are similar for adenocarcinoma of the gastroesophageal junction and the distal esophagus. J Thorac Cardiovasc Surg. 2009;138:594–602.

    Article  PubMed  Google Scholar 

  174. Blank S, et al. Surgical strategies in true adenocarcinoma of the esophagogastric junction (AEG II): thoracoabdominal or abdominal approach? Gastric Cancer. 2018;21:303–14.

    Article  PubMed  Google Scholar 

  175. Parry K, et al. Surgical treatment of adenocarcinomas of the gastro-esophageal junction. Ann Surg Oncol. 2015;22:597–603.

    Article  CAS  PubMed  Google Scholar 

  176. Kurokawa Y, Sasako M, Doki Y. Treatment approaches to esophagogastric junction tumours. Dig Surg. 2013;30:169–73.

    Article  CAS  PubMed  Google Scholar 

  177. Martin JT, Mahan A, Zwischenberger JB, McGrath PC, Tzeng CW. Should gastric cardia cancers be treated with esophagectomy or total gastrectomy? A comprehensive analysis of 4,996 NSQIP/SEER patients. J Am Coll Surg. 2015;220:510–20.

    Article  PubMed  Google Scholar 

  178. Sasako M, et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol. 2006;7:644–51.

    Article  PubMed  Google Scholar 

  179. Barbour AP, et al. Health-related quality of life among patients with adenocarcinoma of the gastro-oesophageal junction treated by gastrectomy or oesophagectomy. Br J Surg. 2008;95:80–4.

    Article  CAS  PubMed  Google Scholar 

  180. Koeter M, et al. Perioperative treatment, not surgical approach, influences overall survival in patients with gastroesophageal junction tumours: a nationwide, population-based study in The Netherlands. Ann Surg Oncol. 2016;23:1632–8.

    Article  PubMed  Google Scholar 

  181. Verhage RJ, Zandvoort HJ, ten Kate FJ, van Hillegersberg R. How to define a positive circumferential resection margin in T3 adenocarcinoma of the esophagus. Am J Surg Pathol. 2011;35:919–26.

    Article  PubMed  Google Scholar 

  182. Rosa F, et al. Total vs proximal gastrectomy for adenocarcinoma of the upper third of the stomach: a propensity-score-matched analysis of a multicenter western experience (On behalf of the Italian Research Group for Gastric Cancer-GIRCG). Gastric Cancer. 2018;21:845.

    Article  PubMed  Google Scholar 

  183. Wen L, et al. Total vs. proximal gastrectomy for proximal gastric cancer: a systematic review and meta-analysis. Hepato-Gastroenterology. 2012;59:633–40.

    PubMed  Google Scholar 

  184. Wang JB, et al. The prognostic relevance of parapyloric lymph node metastasis in Siewert type II/III adenocarcinoma of the esophagogastric junction. Eur J Surg Oncol. 2017;43:2333–40.

    Article  PubMed  Google Scholar 

  185. Son MW, Kim YJ, Jeong GA, Cho GS, Lee MS. Long-term outcomes of proximal gastrectomy versus total gastrectomy for upper-third gastric cancer. J Gastric Cancer. 2014;14:246–51.

    Article  PubMed  PubMed Central  Google Scholar 

  186. Sugoor P, et al. Proximal gastrectomy versus total gastrectomy for proximal third gastric cancer: total gastrectomy is not always necessary. Langenbeck’s Arch Surg. 2016;401:687–97.

    Google Scholar 

  187. Meier I, et al. Adenocarcinoma of the esophagogastric junction: the pattern of metastatic lymph node dissemination as a rationale for elective lymphatic target volume definition. Int J Radiat Oncol Biol Phys. 2008;70:1408–17.

    Article  PubMed  Google Scholar 

  188. Yuasa N, et al. Clinicopathologic comparison of Siewert type II and III adenocarcinomas of the gastroesophageal junction. World J Surg. 2006;30:364–71.

    Article  PubMed  Google Scholar 

  189. Di Leo A, Zanoni A. Siewert III adenocarcinoma: treatment update. Updat Surg. 2017;69:319–25.

    Article  Google Scholar 

  190. Hosokawa Y, et al. Clinicopathological features and prognostic factors of adenocarcinoma of the esophagogastric junction according to Siewert classification: experiences at a single institution in Japan. Ann Surg Oncol. 2012;19:677–83.

    Article  PubMed  Google Scholar 

  191. Cuschieri A, et al. Patient survival after D1 and D2 resections for gastric cancer: long-term results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer. 1999;79:1522–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  192. Bonenkamp JJ, et al. Extended lymph-node dissection for gastric cancer. N Engl J Med. 1999;340:908–14.

    Article  CAS  PubMed  Google Scholar 

  193. Jiang L, et al. Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer. Br J Surg. 2014;101:595–604.

    Article  CAS  PubMed  Google Scholar 

  194. Lee JH, et al. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer. 2014;14:87–104.

    Article  PubMed  PubMed Central  Google Scholar 

  195. Meyer HJ, et al. [Current S3 guidelines on surgical treatment of gastric carcinoma]. Chirurg. 2012;83:31–37.

    Google Scholar 

  196. Verlato G, et al. Indexes of surgical quality in gastric cancer surgery: experience of an Italian network. Ann Surg Oncol. 2009;16:594–602.

    Article  CAS  PubMed  Google Scholar 

  197. National Comprehensive Cancer Network, Gastric cancer (version 2.2018), vol. 2018; 2018.

    Google Scholar 

  198. Smyth EC, et al. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27:v38–49.

    Article  CAS  PubMed  Google Scholar 

  199. Fujimura T, et al. Selective lymphadenectomy of para-aortic lymph nodes for advanced gastric cancer. Oncol Rep. 2009;22:509.

    Article  PubMed  Google Scholar 

  200. Yonemura Y, et al. Randomized clinical trial of D2 and extended paraaortic lymphadenectomy in patients with gastric cancer. Int J Clin Oncol. 2008;13:132–7.

    Article  PubMed  Google Scholar 

  201. Sasako M, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med. 2008;359:453–62.

    Article  CAS  PubMed  Google Scholar 

  202. Ychou M, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29:1715–21.

    Article  CAS  PubMed  Google Scholar 

  203. Cunningham D, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.

    Article  CAS  PubMed  Google Scholar 

  204. Kelsen DP, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998;339:1979–84.

    Article  CAS  PubMed  Google Scholar 

  205. Schuhmacher C, et al. Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol. 2010;28:5210–8.

    Article  PubMed  PubMed Central  Google Scholar 

  206. Alderson D, et al. Neoadjuvant cisplatin and fluorouracil versus epirubicin, cisplatin, and capecitabine followed by resection in patients with oesophageal adenocarcinoma (UK MRC OE05): an open-label, randomised phase 3 trial. Lancet Oncol. 2017;18:1249–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  207. Al-Batran S-E, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17:1697–708.

    Article  CAS  PubMed  Google Scholar 

  208. van Hagen P, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–84.

    Article  PubMed  Google Scholar 

  209. Oppedijk V, et al. Patterns of recurrence after surgery alone versus preoperative chemoradiotherapy and surgery in the CROSS trials. J Clin Oncol. 2014;32:385–91.

    Article  PubMed  Google Scholar 

  210. Mariette C, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer: final analysis of randomized controlled phase III trial FFCD 9901. J Clin Oncol. 2014;32:2416–22.

    Article  CAS  PubMed  Google Scholar 

  211. Macdonald JS, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–30.

    Article  CAS  PubMed  Google Scholar 

  212. Smalley SR, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol. 2012;30:2327–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  213. Sakuramoto S, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.

    Article  CAS  PubMed  Google Scholar 

  214. Lee J, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol. 2012;30:268–73.

    Article  CAS  PubMed  Google Scholar 

  215. Bang YJ, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315–21.

    Article  CAS  PubMed  Google Scholar 

  216. Cats A, et al. Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial. Lancet Oncol. 2018;19:616–28.

    Article  CAS  PubMed  Google Scholar 

  217. Noh SH, et al. Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): 5-year follow-up of an open-label, randomised phase 3 trial. Lancet Oncol. 2014;15:1389–96.

    Article  CAS  PubMed  Google Scholar 

  218. Stahl M, et al. Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol. 2009;27:851–6.

    Article  CAS  PubMed  Google Scholar 

  219. Stahl M, et al. Preoperative chemotherapy versus chemoradiotherapy in locally advanced adenocarcinomas of the oesophagogastric junction (POET): long-term results of a controlled randomised trial. Eur J Cancer. 2017;81:183–90.

    Article  CAS  PubMed  Google Scholar 

  220. Klevebro F, et al. A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction. Ann Oncol. 2016;27:660–7.

    Article  CAS  PubMed  Google Scholar 

  221. Goodman KA, et al. Initial results of CALGB 80803 (Alliance): a randomized phase II trial of PET scan-directed combined modality therapy for esophageal cancer. J Clin Oncol. 2017;35:1–1.

    Article  Google Scholar 

  222. de Geus-Oei L-F, Slingerland M. PET-guided treatment algorithms in oesophageal cancer: the promise of the near future! J Thorac Dis. 2017;9:2736–9.

    Article  PubMed  PubMed Central  Google Scholar 

  223. Kumagai K, et al. Meta-analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro-oesophageal junctional cancers. Br J Surg. 2014;101:321–38.

    Article  CAS  PubMed  Google Scholar 

  224. Klevebro F, et al. Neoadjuvant chemoradiotherapy may increase the risk of severe anastomotic complications after esophagectomy with cervical anastomosis. Langenbeck’s Arch Surg. 2016;401:323–31.

    Google Scholar 

  225. Koeter M, et al. Influence of the extent and dose of radiation on complications after neoadjuvant chemoradiation and subsequent esophagectomy with gastric tube reconstruction with a cervical anastomosis. Int J Radiat Oncol Biol Phys. 2017;97:813–21.

    Article  CAS  PubMed  Google Scholar 

  226. Thuss-Patience P, Vecchione L, Keilholz U. Should cT2 esophageal cancer get neoadjuvant treatment before surgery? J Thorac Dis. 2017;9:2819–23.

    Article  PubMed  PubMed Central  Google Scholar 

  227. Lordick F, Mariette C, Haustermans K, Obermannova R, Arnold D. Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27:v50–7.

    Article  CAS  PubMed  Google Scholar 

  228. Reynolds JV, et al. ICORG 10-14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). BMC Cancer. 2017;17:401.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  229. Leong T, et al. TOPGEAR: a randomised phase III trial of perioperative ECF chemotherapy versus preoperative chemoradiation plus perioperative ECF chemotherapy for resectable gastric cancer (an international, intergroup trial of the AGITG/TROG/EORTC/NCIC CTG). BMC Cancer. 2015;15:532.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  230. Hoeppner J, et al. ESOPEC: prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286). BMC Cancer. 2016;16:503.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  231. Kang Y-K, et al. A randomized phase III study of neoadjuvant chemotherapy with docetaxel(D), oxaliplatin(O), and S-1(S) (DOS) followed by surgery and adjuvant S-1 vs. surgery and adjuvant S-1 for resectable advanced gastric cancer (PRODIGY). J Clin Oncol. 2015;33:TPS4136.

    Article  Google Scholar 

  232. Bang YJ, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.

    Article  CAS  PubMed  Google Scholar 

  233. Van Cutsem E, et al. HER2 screening data from ToGA: targeting HER2 in gastric and gastroesophageal junction cancer. Gastric Cancer. 2015;18:476–84.

    Article  PubMed  CAS  Google Scholar 

  234. Hofheinz R, et al. HER-FLOT: trastuzumab in combination with FLOT as perioperative treatment for patients with HER2-positive locally advanced esophagogastric adenocarcinoma: a phase II trial of the AIO Gastric Cancer Study Group. J Clin Oncol. 2014;32:4073.

    Article  Google Scholar 

  235. Wilke H, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol. 2014;15:1224–35.

    Article  CAS  PubMed  Google Scholar 

  236. Fuchs CS, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2014;383:31–9.

    Article  CAS  PubMed  Google Scholar 

  237. Grimm JC, Valero V 3rd, Molena D. Surgical indications and optimization of patients for resectable esophageal malignancies. J Thorac Dis. 2014;6:249–57.

    PubMed  PubMed Central  Google Scholar 

  238. Dominioni L, Rovera F, Pericelli A, Imperatori A. The rationale of early enteral nutrition. Acta Biomed. 2003;74(Suppl 2):41–4.

    PubMed  Google Scholar 

  239. Madhusudhan C, et al. Palliative stenting for relief of dysphagia in patients with inoperable esophageal cancer: impact on quality of life. Dis Esophagus. 2009;22:331–6.

    Article  PubMed  Google Scholar 

  240. Sgourakis G, et al. The use of self-expanding stents in esophageal and gastroesophageal junction cancer palliation: a meta-analysis and meta-regression analysis of outcomes. Dig Dis Sci. 2010;55:3018–30.

    Article  PubMed  Google Scholar 

  241. Homs MY, et al. Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: multicentre randomised trial. Lancet. 2004;364:1497–504.

    Article  PubMed  Google Scholar 

  242. Spaander MC, et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016;48:939–48.

    Article  PubMed  Google Scholar 

  243. Didden P, et al. Fully vs. partially covered selfexpandable metal stent for palliation of malignant esophageal strictures: a randomized trial (the COPAC study). Endoscopy. 2018;50:961.

    Article  PubMed  Google Scholar 

  244. Coron E, et al. Antireflux versus conventional self-expanding metallic Stents (SEMS) for distal esophageal cancer: results of a multicenter randomized trial. Endosc Int Open. 2016;4:E730–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  245. Blomberg J, et al. Antireflux stent versus conventional stent in the palliation of distal esophageal cancer. A randomized, multicenter clinical trial. Scand J Gastroenterol. 2010;45:208–16.

    Article  PubMed  Google Scholar 

  246. Dai Y, et al. Interventions for dysphagia in oesophageal cancer. Cochrane Database Syst Rev. 2014;(10):Cd005048.

    Google Scholar 

  247. Adamson D, et al. Palliative radiotherapy in addition to self-expanding metal stent for improving dysphagia and survival in advanced oesophageal cancer (ROCS: Radiotherapy after Oesophageal Cancer Stenting): study protocol for a randomized controlled trial. Trials. 2014;15:402.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  248. Javed A, et al. Palliative stenting with or without radiotherapy for inoperable esophageal carcinoma: a randomized trial. J Gastrointest Cancer. 2012;43:63–9.

    Article  CAS  PubMed  Google Scholar 

  249. Wong R, Malthaner R. Combined chemotherapy and radiotherapy (without surgery) compared with radiotherapy alone in localized carcinoma of the esophagus. Cochrane Database Syst Rev. 2006;(1):Cd002092.

    Google Scholar 

  250. Song T, Liang X, Fang M, Wu S. High-dose versus conventional-dose irradiation in cisplatin-based definitive concurrent chemoradiotherapy for esophageal cancer: a systematic review and pooled analysis. Expert Rev Anticancer Ther. 2015;15:1157–69.

    Article  CAS  PubMed  Google Scholar 

  251. Minsky BD, et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol. 2002;20:1167–74.

    Article  CAS  PubMed  Google Scholar 

  252. Chau I, et al. The impact of primary tumour origins in patients with advanced oesophageal, oesophago-gastric junction and gastric adenocarcinoma—individual patient data from 1775 patients in four randomised controlled trials. Ann Oncol. 2009;20:885–91.

    Article  CAS  PubMed  Google Scholar 

  253. Cunningham D, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358:36–46.

    Article  CAS  PubMed  Google Scholar 

  254. Wagner AD, et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev. 2010;(3):Cd004064.

    Google Scholar 

  255. Mohammad NH, et al. Optimal first-line chemotherapeutic treatment in patients with locally advanced or metastatic esophagogastric carcinoma: triplet versus doublet chemotherapy: a systematic literature review and meta-analysis. Cancer Metastasis Rev. 2015;34:429–41.

    Article  PubMed  CAS  Google Scholar 

  256. Enzinger PC, et al. CALGB 80403 (Alliance)/E1206: a randomized phase II study of three chemotherapy regimens plus cetuximab in metastatic esophageal and gastroesophageal junction cancers. J Clin Oncol. 2016;34:2736–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  257. Al-Batran SE, et al. The feasibility of triple-drug chemotherapy combination in older adult patients with oesophagogastric cancer: a randomised trial of the Arbeitsgemeinschaft Internistische Onkologie (FLOT65+). Eur J Cancer. 2013;49:835–42.

    Article  PubMed  Google Scholar 

  258. Wang J, et al. Randomized multicenter phase III study of a modified docetaxel and cisplatin plus fluorouracil regimen compared with cisplatin and fluorouracil as first-line therapy for advanced or locally recurrent gastric cancer. Gastric Cancer. 2016;19:234–44.

    Article  CAS  PubMed  Google Scholar 

  259. Bergquist H, et al. Stent insertion or endoluminal brachytherapy as palliation of patients with advanced cancer of the esophagus and gastroesophageal junction. Results of a randomized, controlled clinical trial. Dis Esophagus. 2005;18:131–9.

    Article  CAS  PubMed  Google Scholar 

  260. Rudiger Siewert J, Feith M, Werner M, Stein HJ. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg. 2000;232:353–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  261. Siewert JR, Stein HJ, Feith M. Adenocarcinoma of the esophago-gastric junction. Scand J Surg. 2006;95:260–9.

    Article  CAS  PubMed  Google Scholar 

  262. Walsh TN, et al. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med. 1996;335:462–7.

    Article  CAS  PubMed  Google Scholar 

  263. Urba SG, et al. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19:305–13.

    Article  CAS  PubMed  Google Scholar 

  264. Burmeister BH, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol. 2005;6:659–68.

    Article  PubMed  Google Scholar 

  265. Tepper J, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26:1086–92.

    Article  CAS  PubMed  Google Scholar 

  266. Burmeister BH, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer. 2011;47:354–60.

    Article  PubMed  Google Scholar 

  267. Hosokawa Y, Kinoshita T, Konishi M, Takahashi S, Gotohda N, Kato Y, et al. Clinicopathological features and prognostic factors of adenocarcinoma of the esophagogastric junction according to Siewert classification: experiences at a single institution in Japan. Ann Surg Oncol. 2012;19:677–83.

    Article  PubMed  Google Scholar 

  268. Yoon SS, Yang HK. Lymphadenectomy for gastric adenocarcinoma: should west meet east? Oncologist. 2009;14:871–82.

    Article  PubMed  Google Scholar 

  269. Zhang XD, Shu YQ, Liang J, Zhang FC, Ma XZ, Huang JJ, et al. Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: a multicenter prospective study. Chin J Cancer Res. 2012;24:291–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  270. Wang G, Wu A, Cheng X, Ji J. Risk factors associated with early recurrence of adenocarcinoma of gastroesophageal junction after curative resection. Chin J Cancer Res. 2013;25:334–8.

    PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, India

    Rajneesh Kumar Singh

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  1. Rajneesh Kumar Singh
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  1. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Peush Sahni

  2. Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India

    Sujoy Pal

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Singh, R.K. (2019). Esophagogastric Junction (EGJ) Carcinoma: An Updated Review. In: Sahni, P., Pal, S. (eds) GI Surgery Annual. GI Surgery Annual, vol 25. Springer, Singapore. https://doi.org/10.1007/978-981-13-3227-2_1

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