Results of the different surgical options for the treatment of cancer of the esophagogastric junction: Review of the evidence

Cir Esp (Engl Ed). 2019 Oct;97(8):445-450. doi: 10.1016/j.ciresp.2019.03.005. Epub 2019 Apr 23.
[Article in English, Spanish]

Abstract

There is significant controversy in the management of cardiac cancer. It seems unanimous that Siewert type I tumors be operated on as cancer of the esophagus and Siewert type III as gastric cancer. However, for "true" cancer of the gastric cardia or Siewert II, the authors do not agree. There is the obvious need for free proximal and distal margins, as well as correct lymphadenectomy. For some, esophagectomy is necessary to perform correct radical oncological surgery, but other authors defend that an abdominal approach is sufficient to perform total gastrectomy and distal esophagectomy. Recent and older papers published do not clarify this issue, and their results are contradictory. Chemotherapy prior to surgery can reduce the size of the tumor and the presence of lymphadenopathies.

Keywords: Cardia; Cardias; Esofaguectomía; Esophagectomy; Esophagus; Estómago; Esófago; Gastrectomy; Gastrectomía; Siewert; Stomach.

Publication types

  • Review

MeSH terms

  • Cardia / pathology
  • Cardia / surgery*
  • Esophageal Neoplasms / classification
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery*
  • Gastrectomy / methods*
  • Humans
  • Lymph Node Excision / methods
  • Margins of Excision
  • Quality of Life
  • Stomach Neoplasms / classification
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome
  • Tumor Burden / drug effects