Lin Daniel, Khan Uqba, Goetze Thorsten O, Reizine Natalie, Goodman Karyn A, Shah Manish A, Catenacci Daniel V, Al-Batran Salah-Eddin, Posey James A
1 Thomas Jefferson University Hospital, Sidney Kimmel Cancer Center, Philadelphia, PA.
2 Weill Cornell Medicine, NU Presbyterian Hospital, New York, NY.
Am Soc Clin Oncol Educ Book. 2019 Jan;39:e88-e95. doi: 10.1200/EDBK_236827. Epub 2019 May 17.
The incidence of gastroesophageal junction (GEJ) adenocarcinomas has been rising over the past few decades, creating a need for effective therapeutic strategies. Treatment of locally advanced GEJ tumors, in particular, present a unique challenge because these tumors have generally been approached as either esophageal or gastric cancers, and thus optimal preoperative management remains uncertain. Both neoadjuvant chemoradiation and perioperative chemotherapy have been widely adopted in standard practice; however, it is unclear which approach offers the optimal outcome for the fit patient capable of receiving any planned strategy. In this review, we debate the management of locally advanced GEJ adenocarcinoma, and discuss areas of ongoing investigation which may provide more effective and individualized treatment of patients with GEJ cancers.
在过去几十年中，胃食管交界（GEJ）腺癌的发病率一直在上升，因此需要有效的治疗策略。特别是局部晚期GEJ肿瘤的治疗面临着独特的挑战，因为这些肿瘤通常被当作食管癌或胃癌来处理，所以最佳的术前管理仍不明确。新辅助放化疗和围手术期化疗在标准治疗中都已被广泛采用；然而，对于适合接受任何计划策略的患者，尚不清楚哪种方法能带来最佳疗效。在本综述中，我们对局部晚期GEJ腺癌的管理进行了探讨，并讨论了正在进行研究的领域，这些领域可能为GEJ癌症患者提供更有效、更个体化的治疗。
