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adenocarcinoma of esophagogastric junction:controversial classification,surgical management,and clinicopathology

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Chinese Journal of Cancer Research 2014年第3期26卷 226-230页

作者： Lei Huang A-Man Xu Department of Gastrointestinal Surgery the Fourth Affiliated Hospital of Anhui Medical University Department of Gastrointestinal Surgery the First Affiliated Hospital of Anhui Medical University

In recent years the world is witnessing an increasing incidence of adenocarcinoma of esophagogastric junction （AEG）, which originates from epithelial tissue of esophagogastric junction （EGJ）, and mainly derives from Barrett＇s esophagus. It＇s now gaining more and more attention due to the controversial etiology, classification and treatment.

关键词： adenocarcinoma of esophagogastric junction AEG node than TNM NAC

Exploration and optimization of surgical techniques for laparoscopic transhiatal lower mediastinal lymph node dissection for adenocarcinoma of esophagogastric junction: A prospective IDEAL 2a study with qualitative design

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Chinese Journal of Cancer Research 2023年第2期35卷 163-175页

作者： Yinkui Wang Fanling Hong Shuangxi Li Fei Shan Yongning Jia Rulin Miao Zhemin Li Ziyu Li Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Gastrointestinal Cancer CenterPeking University Cancer Hospital&InstituteBeijing 100142China Endoscopy Center Zhongshan HospitalFudan University(Xiamen Branch)Xiamen 361015China

Objective: To explore the change and feasibility of surgical techniques of laparoscopic transhiatal(TH)-lower mediastinal lymph node dissection(LMLND) for adenocarcinoma of the esophagogastric junction(AEG)according to Idea, Development, Exploration, Assessment, and Long-term follow-up(IDEAL) 2a ***: Patients diagnosed with AEG who underwent laparoscopic TH-LMLND were prospectively included from April 14, 2020, to March 26, 2021. Clinical and pathological information as well as surgical outcomes were quantitatively analyzed. Semistructured interviews with the surgeon after each operation were qualitatively ***: Thirty-five patients were included. There were no cases of transition to open surgery, but three cases involved combination with transthoracic surgery. In qualitative analysis, 108 items under three main themes were detected: explosion, dissection, and reconstruction. Revised instruction was subsequently designed according to the change in surgical technique and the cognitive process behind it. Three patients had anastomotic leaks postoperatively, with one classified as Clavien-Dindo Ⅲ***: The surgical technique of laparoscopic TH-LMLND is stable and feasible;further IDEAL 2b research is warranted.

关键词： adenocarcinoma of esophagogastric junction laparoscopic surgery transhiatal approach lower mediastinal lymph node dissection IDEAL 2a research

A case of Photodynamic Therapy for Advanced adenocarcinoma of esophagogastric junction

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Journal of Clinical and Nursing Research 2020年第6期4卷 58-62页

作者： Wanlu Cai Xiaoxiong Hu Jianwen Sheng Huizhen Fan School of Chemistry and Biological Engineering Yichun UniversityYichun 336000China Department of Gastroenterology Yichun people's HospitalYichun 336000China

Photodynamic therapy(PDT)is a new minimally invasive technique for the treatment of *** with traditional treatments such as surgery,radiotherapy and chemotherapy,PDT has the advantages of targeted killing of primary and recurrent tumor cells,less damage to surrounding normal tissue,less complications and high repetition *** purpose of this study was to investigate the short-term efficacy and adverse reactions of photodynamic therapy in advanced elderly patients with esophageal-gastric junction adenocarcinoma without surgical indications.A patient with advanced adenocarcinoma of esophagus and fundus was treated with photodynamic therapy under *** drip of Cipofen(hematoporphyrin injection 150mg/0.9%saline 250ml)for 1 hour to keep the patient away from light.48 hours after administration,photodynamic therapy was performed with"Leimai"PDT630-A photodynamic therapy apparatus,3cm columnar optical fiber,laser treatment wavelength of 630nm,transmission efficiency of 0.70,output power of 1.4W,irradiation at the lower segment of the esophagus and cardia for *** curative effect was evaluated by comparing gastroscopy before and after photodynamic *** treatment,there were proliferative lesions in the lower part of esophagus and cardia,erosion and necrosis on the surface,stricture of esophageal cavity,huge ulcer near gastric fundus,filthy moss and dam-like hyperplasia and eminence of surrounding *** treatment,the local mucosa at the entrance of cardia became white and there was no *** four days after treatment,the symptoms of nausea and vomiting disappeared;the adverse reaction of retrosternal discomfort began to occur on the second day after operation,and the adverse reaction was not improved after photodynamic *** therapy has a significant short-term effect on advanced elderly patients with adenocarcinoma of the esophagogastric junction,which can significantly alleviate the clinical sympt

关键词： Photodynamic therapy Gastric cancer adenocarcinoma of esophagogastric junction Short-term efficacy Adverse reactions,Hippofen

Recent advances in multidisciplinary therapy for adenocarcinoma of the esophagus and esophagogastric junction

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World Journal of Gastroenterology 2022年第31期28卷 4299-4309页

作者： Yi-Han Zheng En-Hao Zhao Department of Gastrointestinal Surgery Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

Esophageal adenocarcinoma(EAC)and adenocarcinoma of the esophagogastric junction(EGJA)have long been associated with poor *** changes in the spectrum of the disease caused by economic development and demographic changes,the incidence of EAC and EGJA continues to increase,making them worthy of more attention from *** a long time,surgery has been the mainstay treatment for EAC and *** advanced techniques,endoscopic therapy,radiotherapy,chemotherapy,and other treatment methods have been developed,providing additional treatment options for patients with EAC and *** recent decades,the emergence of multidisciplinary therapy(MDT)has enabled the comprehensive treatment of tumors and made the treatment more flexible and diversified,which is conducive to achieving standardized and individualized treatment of EAC and EGJA to obtain a better *** review discusses recent advances in EAC and EGJA treatment in the surgicalcentered MDT mode in recent years.

关键词： Multidisciplinary therapy Esophageal adenocarcinoma adenocarcinoma of esophagogastric junction Endoscopic resection Surgery

Effects of different surgical approaches on Siewert Ⅱ adenocarcinoma of esophagogastric junction

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外科研究与新技术 2012年第1期 29-29页

作者：官国先 Dept Gen Surg Afil Union Hosp Fujian Med Univ

Objective To compare the effects of different surgical approaches on Siewert Ⅱ ( esophageal invasion ≤3 cm) adenocarcinoma of esophagogastric junction. Methods This retrospective study included 251 cases of Siewert Ⅱ adenocarcinoma of esophagogastric junction undergoing D2 or D2 + total gastrectomy by transab-dominal approach ( TA group,128 cases) or left thora-coabdominal approach ( LTA group,123 cases) . Operation time,blood loss,extent of esophageal resection, number of lymph nodes dissected,morbidity,mortality

关键词： LTA adenocarcinoma of esophagogastric junction Effects of different surgical approaches on Siewert

Comparison of survival outcomes between transthoracic and transabdominal surgical approaches in patients with Siewert-Ⅱ/Ⅲesophagogastric junction adenocarcinoma:a single-institution retrospective cohort study

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Chinese Journal of Cancer Research 2016年第4期28卷 413-422页

作者： Weihan Zhang Xinzu Chen Kai Liu Kun Yang Xiaolong Chen Ying Zhao Yongfan Zhao Jiaping Chen Longqi Chen Jiankun Hu Department of Gastrointestinal Surgery West China HospitalSichuan UniversityChengdu 610041China Institute of Gastric Cancer State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu 610041China Department of Discipline Construction West China HospitalSichuan UniversityChengdu 610041China Department of Thoracic Surgery West China HospitalSichuan UniversityChengdu 610041China

Objective： To compare the survival outcomes of transabdominal （TA） and transthoracic （TT） surgical approaches in patients with Siewert-II/III esophagogastric junction adenocarcinoma. Methods： This retrospective study was conducted in patients with Siewert-II/III esophagogastric junction adenocarcinoma who underwent either TT or TA operations in the West China Hospital between January 2006 and December 2009. Results： A total of 308 patients （109 in the TT and 199 in the TA groups） were included in this study with a follow-up rate of 87.3%. The median （P25, P75） number of harvested perigastric lymph nodes was 8 （5, 10） in the TT group and 23 （16, 34） in the TA group （P〈0.001）, and the number of positive perigastric lymph nodes was 2 （0, 5） in the TT group and 3 （1, 8） in the TA group （P〈0.004）. The 5-year overall survival （OS） rate was 36% in the TT group and 51% in the TA group （P=0.005）. Subgroup analysis by Siewert classification showed that 5-year OS rates for patients with Siewert II tumors were 38% and 48% in TT and TA groups, respectively （P=0.134）, whereas the 5-year OS rate for patients with Siewert III tumors was significantly lower in the TT group than that in the TA group （33% vs. 53%; P=0.010）. Multivariate analysis indicated that N2 and N3 stages, RI/R2 resection and a TT surgical approach were prognostic factors for poor OS. Conclusions： Improved perigastric lymph node dissection may be the main reason for better survival outcomes observed with a TA gastrectomy approach than with TT gastrectomy for Siewert III tumor patients.

关键词： Siewert classification adenocarcinoma of esophagogastric junction transthoracic transabdominal prognosis