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食管胃结合部癌的外科和围手术期治疗。

Surgical and Perioperative Treatments for Esophagogastric Junction Cancer.

机构信息

Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.ra.24-00056.

Abstract

Esophagogastric junction cancer (EGJC) is a rare malignant disease that occurs in the gastroesophageal transition zone. In recent years, its incidence has been rapidly increasing not only in Western countries but also in East Asia, and it has been attracting the attention of both clinicians and researchers. EGJC has a worse prognosis than gastric cancer (GC) and is characterized by complex lymphatic drainage pathways in the mediastinal and abdominal regions. EGJC was previously treated in the same way as GC or esophageal cancer, but, in recent years, it has been treated as an independent malignant disease, and treatment focusing only on EGJC has been developed. A recent multicenter prospective study revealed the frequency of lymph node metastasis by station and established the optimal extent of lymph node dissection. In perioperative treatment, the combination of multi-drug chemotherapy, radiation therapy, molecular targeted therapy, and immunotherapy is expected to improve the prognosis. In this review, we summarize previous clinical trials and their important evidence on surgical and perioperative treatments for EGJC.

摘要

食管胃结合部癌(EGJC)是一种罕见的恶性疾病,发生在胃食管过渡区。近年来,它在西方国家和东亚的发病率都在迅速上升,引起了临床医生和研究人员的关注。EGJC 的预后比胃癌(GC)更差,其特点是纵隔和腹部区域的淋巴引流途径复杂。EGJC 以前的治疗方法与 GC 或食管癌相同,但近年来,它被视为一种独立的恶性疾病,仅针对 EGJC 的治疗方法也得到了发展。最近的一项多中心前瞻性研究揭示了淋巴结转移的站别频率,并确定了淋巴结清扫的最佳范围。在围手术期治疗中,多药化疗、放疗、分子靶向治疗和免疫治疗的联合应用有望改善预后。在这篇综述中,我们总结了 EGJC 手术和围手术期治疗的先前临床试验及其重要证据。

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