Surgical and Perioperative Treatments for Esophagogastric Junction Cancer.

Yoshitomo Yanagimoto, Yukinori Kurokawa, Yuichiro Doki
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Abstract

Esophagogastric junction cancer (EGJC) is a rare malignant disease that occurs in the gastroesophageal transition zone. In recent years, its incidence has been rapidly increasing not only in Western countries but also in East Asia, and it has been attracting the attention of both clinicians and researchers. EGJC has a worse prognosis than gastric cancer (GC) and is characterized by complex lymphatic drainage pathways in the mediastinal and abdominal regions. EGJC was previously treated in the same way as GC or esophageal cancer, but, in recent years, it has been treated as an independent malignant disease, and treatment focusing only on EGJC has been developed. A recent multicenter prospective study revealed the frequency of lymph node metastasis by station and established the optimal extent of lymph node dissection. In perioperative treatment, the combination of multi-drug chemotherapy, radiation therapy, molecular targeted therapy, and immunotherapy is expected to improve the prognosis. In this review, we summarize previous clinical trials and their important evidence on surgical and perioperative treatments for EGJC.

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食管胃交界癌的手术和围手术期治疗。
食管胃交界癌(EGJC)是一种发生在胃食管过渡区的罕见恶性疾病。近年来,其发病率不仅在西方国家迅速上升,在东亚地区也同样如此,并引起了临床医生和研究人员的关注。与胃癌(GC)相比,EGJC 的预后更差,其特点是纵隔和腹腔淋巴引流路径复杂。以前,EGJC 的治疗方法与胃癌或食管癌相同,但近年来,EGJC 已被作为一种独立的恶性疾病来治疗,并发展出只针对 EGJC 的治疗方法。最近的一项多中心前瞻性研究显示了各站淋巴结转移的频率,并确定了淋巴结清扫的最佳范围。在围手术期治疗中,多种药物化疗、放射治疗、分子靶向治疗和免疫治疗的联合应用有望改善预后。在这篇综述中,我们总结了以往的临床试验及其对 EGJC 手术和围手术期治疗的重要证据。
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