Zhang Shun, Orita Hajime, Fukunaga Tetsu
Department of Gastroenterology Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai 200120, China.
Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, Tokyo 113-8431, Japan.
World J Gastrointest Oncol. 2019 Aug 15;11(8):567-578. doi: 10.4251/wjgo.v11.i8.567.
The incidence of esophagogastric junction (EGJ) adenocarcinoma has shown an upward trend over the past several decades worldwide. In this article, we review previous studies and aimed to provide an update on the factors related to the surgical treatment of EGJ adenocarcinoma. The Siewert classification has implications for lymph node spread and is the most commonly used classification. Different types of EGJ cancer have different incidences of mediastinal and abdominal lymph node metastases, and different surgical approaches have unique advantages and disadvantages. Minimally invasive surgeries have been increasingly applied in clinical practice and show comparable oncologic outcomes. Endoscopic resection may be a good therapy for early EGJ cancer. Additionally, there is still a great need for well-designed, large RCTs to forward our knowledge on the surgical treatment of EGJ cancer.
在过去几十年间，全球范围内食管胃交界（EGJ）腺癌的发病率呈上升趋势。在本文中，我们回顾了既往研究，旨在就与EGJ腺癌外科治疗相关的因素提供最新信息。Siewert分类对淋巴结转移情况有影响，是最常用的分类方法。不同类型的EGJ癌发生纵隔和腹部淋巴结转移的发生率不同，不同的手术方式各有其独特的优缺点。微创手术在临床实践中的应用日益增多，且显示出相当的肿瘤学疗效。内镜切除可能是早期EGJ癌的一种良好治疗方法。此外，仍迫切需要设计良好的大型随机对照试验，以增进我们对EGJ癌外科治疗的认识。
