| Theme |
Lesions of Esophagogastric Junction -- Its Diagnostic and Therapeutic Strategies |
| Title |
Clinical Characteristics and Management of Carcinoma of the Esophagogastric Junction |
| Author |
Takashi Ichikura |
Department of Surgery I, National Defense Medical College |
| Author |
Toshiya Ogawa |
Department of Surgery I, National Defense Medical College |
| Author |
Hidetaka Mochizuki |
Department of Surgery I, National Defense Medical College |
| [ Summary ] |
The incidence of adenocarcinoma of the gastric cardia has been reported to have increased in the West. Although carcinoma of the cardia or carcinoma of the esophagogastric junction (EGJ) has been diversely defined, we believe that cardia carcinoma should be defined as adenocarcinoma with its epicenter between 1cm proximal and 2cm distal to the EGJ. Cardia carcinomas were associated with a higher male/female ratio and higher incidences of differentiated histology as well as a well delineated appearance, as compared to adenocarcinomas of the upper third of the stomach without esophageal invasion. The differences in the clinicopathologic features of cardia carcinoma and carcinoma of the upper third of the stomach are more prominent than those between carcinoma of the upper third of the stomach and carcinoma of the middle or lower third. Metastases to the lymph nodes along the right gastroepiploic artery and supra-and infra-pyloric nodes were uncommon in cardia carcinomas, which suggests that proximal gastrectomy can be applied as a treatment for this type of tumor. Thus, adenocarcinoma of the cardia should be categorized as a distinct entity independent of carcinoma of the upper third of the stomach. It remains to be elucidated whether any difference in clinical features or appropriate management exists between squamous cell carcinomas of the EGJ and adenocarcinomas of the EGJ. |