Based on Siewert classification: controversy progress of the integration of type<b> Ⅱ </b>of adenocarcinoma of esophagogastric junction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHENG Jie ^1,2 ,  HUANG Bo ²

1. Shanxi Medical University, Taiyuan 030001, P. R. China;
2. Department of Gastrointestinal Surgery, People’s Hospital Affiliated to Shanxi Medical University,Taiyuan 030012, P. R. China;

Corresponding?author：

HUANG Bo, Email: huangbo1408@sina.com

Keywords：

adenocarcinoma of esophagogastric junction; stage; surgical treatment; laparoscopic treatment; adjuvant therapy

DOI：

10.7507/1007-9424.202011053

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review and summarize the research progress of adenocarcinoma of esophagogastric junction (AEG) in staging, surgical treatment, endoscopic treatment and adjuvant therapy in recent years, so as to provide reference and help for the follow-up research and treatment of this disease.Method Literature review was used to review the literatures on AEG treatment in various databases.Results The incidence of AEG had increased rapidly in recent years, with high malignancy and poor prognosis. Siewert typing had allowed researchers to gain insight into the disease, and treatments were increasingly diversified. At present, the main treatment was still radical surgery. Because AEG was adjacent to the esophagus and stomach, there were many controversies about its staging, surgical approach, resection range, digestive tract reconstruction, adjuvant treatment and so on, especially Siewert type Ⅱ.Conclusions The surgical approach, resection range, and laparoscopic surgery of Siewert typeⅡcan choose according to esophageal involvement distance judgment, pathological staging is uncertain, still need several studies to reach a consensus. With the application of laparoscopy and adjuvant therapy, how to select individualized treatment options that require multidisciplinary collaboration for further study.

Citation： CHENG Jie, HUANG Bo. Based on Siewert classification: controversy progress of the integration of type Ⅱ of adenocarcinoma of esophagogastric junction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(9): 1254-1260. doi: 10.7507/1007-9424.202011053 Copy

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2. 國際食管疾病學會中國分會(CSDE)食管胃結合部疾病跨界聯盟, 中國醫師協會內鏡醫師分會腹腔鏡外科專業委員會, 中國醫師協會外科醫師分會上消化道外科醫師專業委員會中華醫學會, 等. 食管胃結合部腺癌外科治療中國專家共識(2018年版). 中華胃腸外科雜志, 2018, 21(9): 961-975.
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4. Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11^th Edition: part Ⅰ. Esophagus, 2017, 14(1): 1-36.
5. 季加孚, 季科. 食管胃結合部腺癌外科治療進展. 中國普外基礎與臨床雜志, 2019, 26(9): 1021-1024.
6. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
7. Liu K, Yang K, Zhang W, et al. Changes of esophagogastric junctional adenocarcinoma and gastroesophageal reflux disease among surgical patients during 1988-2012: a single-institution, high-volume experience in China. Ann Surg, 2016, 263(1): 88-95.
8. 楊宏, 武愛文, 季加孚, 等. 食管胃結合部腺癌471例Siewert分型臨床研究. 中國實用外科雜志, 2012, 32(4): 310-315.
9. Zhang Y, Liu D, Zeng D, et al. Lymph node ratio is an independent prognostic factor for patients with Siewert type Ⅱ adenocarcinoma of esophagogastric junction: results from a 10-year follow-up study. J Gastrointest Cancer, 2020 Sep 21. Online ahead of print.
10. Sugita S, Kinoshita T, Kuwata T, et al. Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction. Surg Endosc, 2021, 35(1): 340-348.
11. 李浩淼, 孫海波, 鄭燕, 等. AJCC/UICC第八版食管及食管胃交界部癌TNM分期解讀及中文版主要內容. 中國胸心血管外科臨床雜志, 2017, 24(2): 87-92.
12. 郗洪慶, 張珂誠, 衛勃, 等. 胃癌TNM分期第八版更新在臨床診斷治療中的意義和思考. 中華胃腸外科雜志, 2017, 20(2): 166-170.
13. Hasegawa S, Yoshikawa T, Aoyama T, et al. Esophagus or stomach? The seventh TNM classification for Siewert type Ⅱ/Ⅲ junctional adenocarcinoma. Ann Surg Oncol, 2013, 20(3): 773-779.
14. 陜飛, 李子禹, 張連海, 等. 國際抗癌聯盟及美國腫瘤聯合會胃癌TNM分期系統(第8版)簡介及解讀. 中國實用外科雜志, 2017, 37(1): 15-17.
15. Liu K, Feng F, Chen XZ, et al. Comparison between gastric and esophageal classification system among adenocarcinomas of esophagogastric junction according to AJCC 8th edition: a retrospective observational study from two high-volume institutions in China. Gastric Cancer, 2019, 22(3): 506-517.
16. Cancer Genome Atlas Research Network, Analysis Working Group: Asan University, BC Cancer Agency, et al. Integrated genomic characterization of oesophageal carcinoma. Nature, 2017, 541(7636): 169-175.
17. Barra WF, Moreira FC, Pereira Cruz AM, et al. GEJ cancers: gastric or esophageal tumors? searching for the answer according to molecular identity. Oncotarget, 2017, 8(61): 104286-104294.
18. Suh YS, Na D, Lee JS, et al. Comprehensive molecular characterization of adenocarcinoma of the gastroesophageal junction between esophageal and gastric adenocarcinomas. Ann Surg, 2020 Oct 19. Online ahead of print.
19. Koyanagi K, Kato F, Kanamori J, et al. Clinical significance of esophageal invasion length for the prediction of mediastinal lymph node metastasis in Siewert type Ⅱ adenocarcinoma: A retrospective single-institution study. Ann Gastroenterol Surg, 2018, 2(3): 187-196.
20. 高軍, 李富良, 何旭. Ⅱ/Ⅲ型胃食管結合部腺癌淋巴結轉移的影響因素及其對預后的影響. 中國普外基礎與臨床雜志, 2018, 25(11): 1327-1331.
21. Mitchell KG, Ikoma N, Nelson DB, et al. Mediastinal nodal involvement after neoadjuvant chemoradiation for Siewert Ⅱ/Ⅲ adenocarcinoma. Ann Thorac Surg, 2019, 108(3): 845-851.
22. Kurokawa Y, Takeuchi H, Doki Y, et al. Mapping of lymph node metastasis from esophagogastric junction tumors: a prospective nationwide multicenter study. Ann Surg, 2019 Aug 8. Online ahead of print.
23. 中華醫學會外科學分會腹腔鏡與內鏡外科學組. Siewert Ⅱ型食管胃結合部腺癌腔鏡手術治療中國專家共識(2019版). 中國實用外科雜志, 2019, 39(11): 1129-1135.
24. 郭偉. 食管胃結合部腺癌的淋巴結清掃范圍. 中國現代普通外科進展, 2020, 23(10): 769-772.
25. 林密, 呂陳彬, 鄭朝輝, 等. 脾門淋巴結清掃在腫瘤長徑≥4 cm的Siewert Ⅱ型和Ⅲ型食管胃結合部腺癌中的應用價值. 中華消化外科雜志, 2016, 15(11): 1055-1061.
26. Lin JX, Zheng CH, Huang CM. Comment on "Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma". Ann Surg, 2019, 269(5): e65.
27. 于振濤, 王海通. 食管胃結合部腺癌外科治療現狀. 中華消化外科雜志, 2019, 18(6): 513-517.
28. Kurokawa Y, Sasako M, Sano T, et al. Ten-year follow-up results of a randomized clinical trial comparing left thoracoabdominal and abdominal transhiatal approaches to total gastrectomy for adenocarcinoma of the oesophagogastric junction or gastric cardia. Br J Surg, 2015, 102(4): 341-348.
29. 楊世界, 袁勇, 劉凱, 等. SiewertⅡ型食管胃結合部腺癌經胸與經腹入路手術的預后比較—胸外科與胃腸外科聯合數據分析. 中華胃腸外科雜志, 2019, 22(2): 132-142.
30. Wu H, Shang L, Du F, et al. Transhiatal versus transthoracic surgical approach for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction: a meta-analysis. Expert Rev Gastroenterol Hepatol, 2020, 14(11): 1107-1117.
31. 胡文慶, 崔鵬, 張晉杰, 等. 經腹食管裂孔入路下縱隔淋巴結清掃在食管胃結合部腺癌手術中的應用. 中國普通外科雜志, 2019, 28(10): 1192-1196.
32. Niclauss N, Jung MK, Chevallay M, et al. Minimal length of proximal resection margin in adenocarcinoma of the esophagogastric junction: a systematic review of the literature. Updates Surg, 2019, 71(3): 401-409.
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Based on Siewert classification: controversy progress of the integration of type Ⅱ of adenocarcinoma of esophagogastric junction

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