Özofagogastrik Bileșke Kanserleri ve Cerrahi Tedavisi
Abstract
Proximal gastric and esophagogastric junction adenocarcinomas (EGJA) are arising in especially western world. In 1998 Siewert published his classification for EGJA which is based on tumors tophography. The 7th edition of AJCC Cancer Staging Manuel includes staging of esophagus and esophagogastric junction cancer
also the first 5 cm of the stomach cancer that invades the esophagogastric junction. For type I tumors the most frequent lymphatic spread is through the paraesophageal and upper abdominal lymph nodes. For type II and type III tumors mediastinal lymphatic invasion frequency is lower. The best treatment for R0 resectable
EGJA without metastases is surgery. It is widely accepted that for type I tumors Iwor Lewis operation, for type III tumors transabdominal total gastrectomy with D2 lymph node dissection are the best treatment. For type II tumors if R0 resection is possible via transabdominal approach, total gastrectomy is appopriate. If R0 resection is not possible with this way, transabdominal and transthorasic esophagectomy should be done with two field lymphadenectomy. Endoscopic resection can be done for submucoal tumors.
Keywords
Esophagogastric Junction, Adenocarcinoma, Surgical Management
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