Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue, J4-1, Cleveland, OH 44195, USA.
Solid Tumor Oncology, Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, R35, Cleveland, OH 44195, USA.
Surg Oncol Clin N Am. 2020 Oct;29(4):647-653. doi: 10.1016/j.soc.2020.07.002. Epub 2020 Aug 12.
It remains uncertain whether Siewert III tumors should be treated as esophageal or gastric cancers. Neoadjuvant therapy has been shown to improve survival in both esophageal and gastric trials. Randomized control trials comparing neoadjuvant chemotherapy versus chemoradiation should help define the most optimal treatment regimen. Surgical treatment follows general oncology principals: resect to negative margins with complete lymph node dissection, and, the extent of resection often extends more proximal onto the esophagus in addition to the total/subtotal gastrectomy.
目前仍不确定 Siewert III 型肿瘤应视为食管或胃癌。新辅助治疗已被证明可提高食管和胃癌试验的生存率。比较新辅助化疗与放化疗的随机对照试验应有助于确定最佳治疗方案。手术治疗遵循一般肿瘤学原则：切除至阴性切缘，完全淋巴结清扫，此外，除全胃/大部分胃切除外，切除范围通常更向食管近端延伸。
