[Retrospect of 2019: focus on the surgical treatment for adenocarcinoma of esophagogastric junction]

Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Jan 25;23(1):20-25. doi: 10.3760/cma.j.issn.1671-0274.2020.01.004.
[Article in Chinese]

Abstract

Adenocarcinoma of esophagogastric junction (AEG) has a special anatomical position. In clinical practice, there are many overplays among thoracic surgeons, gastrointestinal surgeons, gastroenterologists and oncologists. In recent years, AEG has attracted more and more clinical attention with its increasing incidence. It has a tendency to be gradually separated from esophageal cancer and gastric cancer and be defined as a new special type of tumor. At present, there are still many controversies in the definition, classification, TNM staging, surgical approach, extent of resection, lymph node dissection, digestive tract reconstruction and neoadjuvant therapy of AEG. Meanwhile many problems still need to be solved, which is in a stage of gradual improvement and standardization. This article mainly reviews the important research progress in the field of AEG in 2019, summarizes the current clinical hotspots of AEG, especially the surgical treatment hotspots and the current application status of related new technologies, and aims the future development. We suggest that communication and cooperation among multiple disciplines should be strengthened. Through more clinical researches, basic experimental researches, and innovation and application of new technologies, personalized and accurate diagnosis and treatment will be carried out for patients with different conditions to ultimately achieve the common goal of maximizing the benefits of patients.

食管胃结合部腺癌(AEG)因解剖位置特殊,在其实际临床诊治工作中,胸外科、胃肠外科、消化内科及肿瘤科之间存在诸多交互。近年来,AEG发病率呈上升趋势,受到临床广泛关注,并逐渐倾向从食管癌和胃癌的范畴中分离出来,成为一种新的特殊类型肿瘤。目前对于AEG在其定义、分型、TNM分期、手术路径、切除范围、淋巴结清扫范围、消化道重建、术前新辅助治疗等方面尚存在诸多争议,还有许多问题亟待解决,正处于一个逐步完善及规范的阶段。本文主要回顾2019年AEG领域的重要研究进展,总结当下AEG的临床热点,尤其外科治疗热点以及相关新技术的应用现状,并着眼未来的发展。建议应加强各学科之间的沟通、合作以及对疾病的认知,通过更多临床研究、基础实验研究以及新技术的创新及其应用,对不同病情的患者采取个性化及精准的诊疗,最终达到让患者获得最大收益的共同目标。.

Keywords: Adenocarcinoma of esophagogastric junction; Application of new technologies; Hot topics; Surgical advances.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / classification
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Esophageal Neoplasms / classification
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery*
  • Humans
  • Lymph Node Excision / trends
  • Neoplasm Staging
  • Stomach Neoplasms / classification
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*