Management of Esophagogastric Junction Cancer
Albion Totsi, MD, MSc
First Surgical Department, Papageorgiou General Hospital, Thessaloniki, Greece
Email: [email protected]
Presented at the Fourth Clinical Congress of the Kosova College of Surgeons, September 26-29, 2024
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Abstract
The management of Esophagogastric Junction (EGJ) cancer remains a complex issue due to the difficulty in defining it clearly. For this reason, the 8th edition of the TNM classification, defines EGJ adenocarcinoma as the cancer with epicenter located within 2cm proximal or distal to the EGJ which is now considered as esophageal cancer. The diagnosis of EGJ adenocarcinoma is achieved by endoscopy and biopsy while CT, endoscopic ultrasound, PET CT and laparoscopy are essential for the accurate staging of the disease. Treatment of EGJ adenocarcinoma requires a multimodal approach through which the combination of surgery, chemotherapy, immunotherapy and radiotherapy will offer the patient the best possible choice. As surgery remains the cornerstone of curative treatment, the optimal surgical approach (transthoracic or transhiatal surgery) and the extent of lymphadenectomy play critical role in both patient morbidity and overall survival. This review deals with the current practices in the management of EGJ cancer from diagnosis to definitive treatment.
Key words: esophagogastric junction cancer, definition, management, multimodal approach, surgical treatment