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Esophagogastric junction cancer

Tetsushi Nakajima, Tsutomu Sato, Kazuki Kano, Yukio Maezawa, Kenki Segami, Hirohito Fujikawa, Kousuke Ikeda, Takanobu Yamada, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
A 63-year-old man with dysphagia was referred to our hospital. He was found to have a type 2 tumor extending from the lower thoracic esophagus to the esophagogastric junction via upper gastrointestinal endoscopy. A biopsy revealed adenocarcinoma with overexpression of the human epidermal growth factor type 2(HER2). The tumor was type I according to Siewert's classification, as the epicenter of the tumor was 27mm to the oral side from the esophago-gastric junction. The clinical diagnosis was T3N1M1, stage IV according to the Japanese Classification of Gastric Carcinoma, and T3N2M0, stage III per the Japanese Classification of Esophageal Cancer...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Alexander W Phillips, Barry Dent, Maziar Navidi, Arul Immanuel, S Michael Griffin
OBJECTIVE: The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND: Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Esophagogastric cancer training is particularly vulnerable due to the publication of individual surgeon results and a perception that dual consultant operating improves patient outcomes...
October 17, 2016: Annals of Surgery
T W Rice, L-Q Chen, W L Hofstetter, B M Smithers, V W Rusch, B P L Wijnhoven, K L Chen, A R Davies, X B D'Journo, K A Kesler, J D Luketich, M K Ferguson, J V Räsänen, R van Hillegersberg, W Fang, L Durand, I Cecconello, W H Allum, R J Cerfolio, M Pera, S M Griffin, R Burger, J-F Liu, M S Allen, S Law, T J Watson, G E Darling, W J Scott, A Duranceau, C E Denlinger, P H Schipper, T E M R Lerut, M B Orringer, H Ishwaran, C Apperson-Hansen, L M DiPaola, M E Semple, E H Blackstone
We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision...
October 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
K Lehmann, D Eshmuminov, P Bauerfeind, C Gubler, P Veit-Haibach, A Weber, H Abdul-Rahman, M Fischer, C Reiner, P M Schneider
INTRODUCTION: The accuracy of preoperative lymph-node staging in patients with adenocarcinoma of the esophagogastric junction (AEG) or gastric cancer (GC) is low. The aim of this study was to assess the accuracy of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) for lymph-node staging in patients with AEG or GC, with or without neoadjuvant treatment. PATIENTS AND METHODS: 221 consecutive patients with GC (n = 88) or AEG (n = 133) were evaluated...
September 7, 2016: European Journal of Surgical Oncology
H Ptok, I Gastinger, F Meyer, A Ilsemann, H Lippert, C Bruns
BACKGROUND: The impact of hospital and surgeon volume on the treatment outcome based on data obtained from cohort and register studies has been controversially discussed in the international literature. The results of large-scale prospective observational studies within the framework of clinical healthcare research may lead to relevant recommendations in this ongoing discussion. MATERIAL AND METHODS: Within the framework of the prospective multicenter German Gastric Cancer Study 2 (QCGC 2), from 1 January 2007 to 31 December 2009 a total of 2897 patients with the histological diagnosis of gastric cancer from 140 surgical departments were registered and analyzed...
September 27, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
David H Ilson
PURPOSE OF REVIEW: This article reviews the recent seminal studies in esophagogastric cancer. RECENT FINDINGS: Regular low aspirin use may reduce the risk of esophagogastric cancer. Laparoscopic resection of locally advanced gastric cancer appears equivalent to open resection. There is no survival benefit for the addition of postoperative radiation therapy to adjuvant chemotherapy after primary gastric cancer resection. For tumors of the esophagus and gastroesophageal junction, the combination of preoperative radiation therapy with concurrent chemotherapy may be required to ensure achievement of a negative surgical margin and to reduce local tumor recurrence...
November 2016: Current Opinion in Gastroenterology
Hoon Hur, Sang-Yong Son, Yong Kwan Cho, Sang-Uk Han
Determining resection margins for gastric cancer, which are not exposed to the serosal surface of the stomach, is the most important procedure during totally laparoscopic gastrectomy (TLG). The aim of this protocol is to introduce a procedure for intraoperative gastroscopy, in order to directly mark tumors during TLG for gastric cancer in the middle third of the stomach. Patients who were diagnosed with adenocarcinoma in the middle third of the stomach were enrolled in this case series. Before surgery, additional gastroscopy for tumor localization is not performed...
2016: Journal of Visualized Experiments: JoVE
Nuray Kepil, Sebnem Batur, Ceyda Sonmez Wetherilt, Sibel Erdamar Cetin
Accurate identification of human epidermal growth factor receptor 2 (HER-2) status in advanced gastric cancer patients is of utmost importance in terms of treatment planning. This study aimed to examine the HER-2 status in advanced gastric cancer patients using both immunohistochemistry (IHC) and silver in situ hybridization (SISH) techniques and to investigate concordance and diagnostic accuracy. In addition, associations between clinical parameters and HER 2 status were examined. A total of 313 patients diagnosed with locally advanced (Stage III: T3-4, N+) recurrent or metastatic adenocarcinoma of the stomach or esophagogastric junction, between 2009 and 2015, were included...
August 31, 2016: Bosnian Journal of Basic Medical Sciences
Juha Kauppi, Jari Räsänen, Eero Sihvo, Urpo Nieminen, Perttu Arkkila, Markku Ahotupa, Jarmo Salo
OBJECTIVES: Oxidative stress (OS) is an essential element in the pathogenesis of Barrett's esophagus (BE) and its transformation to adenocarcinoma (EAC). The state of OS in the proximal stomach of patients with BE and EAC is unknown. Isoprostanes are a specific marker of OS not previously used to determine OS from BE/EAC tissue samples. PATIENTS AND METHODS: OS was measured in 42 patients with BE (n = 9), EAC (n = 9), or both (n = 24) and 15 control patients. A STAT-8-Isoprostane EIA Kit served to identify 8-Isoprostanes (8-IP), and a Glutathione Assay Kit was used to measure glutathione reduced form (GSH) and glutathione oxidized form...
August 2016: Translational Oncology
Takuya Hattori, Kazuhiro Sentani, Yui Hattori, Naohide Oue, Wataru Yasui
Invasive micropapillary carcinoma (IMPC), an aggressive variant of adenocarcinoma, is associated with a poor prognosis. Although IMPC has been reported to occur in various organs, pure IMPC has only been reported in the breast, pancreas and colon. There are no reports of IMPC of the esophagogastric junction (EGJ). According to previous reports on gastric IMPC, IMPC occupied, at most, 90 % of the whole tumor. IMPC is reported to occur least frequently in the gastric cardia. We herein report a rare case of pure IMPC of the EGJ...
October 2016: Pathology International
Pierfrancesco Franco, Alba Fiorentino, Francesco Dionisi, Michele Fiore, Silvia Chiesa, Stefano Vagge, Francesco Cellini, Luciana Caravatta, Mario Tombolini, Fiorenza De Rose, Icro Meattini, Gianluca Mortellaro, Giuseppina Apicella, Lorenza Marino, Daniela Greto
PURPOSE: Combined modality therapy is a mainstay option for thoracic malignancies and head and neck cancers. The integration of different strategies is based on the multidisciplinary approach of modern clinical oncology. Radiation oncologists have to be educated, trained, and updated to provide state-of-the-art care to cancer patients and thus educational meetings are crucial. METHODS: The Italian Association of Radiation Oncology Young Members Working Group (AIRO Giovani) organized its 8th national meeting, focused on combination therapy in lung, esophageal, and head and neck cancer (with a specific focus on larynx-preservation strategies for larynx/hypopharynx tumors), involving young professionals working in Italy...
October 13, 2016: Tumori
Hideaki Bando, Larry Rubinstein, Pamela Harris, Takayuki Yoshino, Toshihiko Doi, Atsushi Ohtsu, John Welch, Naoko Takebe
BACKGROUND: In phase 1 trials, an important entry criterion is life expectancy predicted to be more than 90 days, which is generally difficult to predict. The Royal Marsden Hospital (RMH) prognostic score that is determined by lactate dehydrogenase level, albumin level, and number of metastatic sites of disease was developed to help project patient outcomes. There have been no systematic analyses to evaluate the utility of the RMH prognostic score for esophagogastric cancer patients...
August 10, 2016: Gastric Cancer
Xiaofei Lu, Lingling Duan, Hongqin Xie, Xiaoxia Lu, Daolin Lu, Daopeng Lu, Nan Jiang, Yuxin Chen
OBJECTIVE: Adenocarcinoma of esophagogastric junction (AEG) is a lethal malignancy featured with early metastasis, poor prognosis, and few treatment options. Matrix metalloproteinase (MMP) and metalloproteinase suppressor (TIMP) have been considered to be associated with cancer invasion and metastasis. In our study, we evaluated expressions of MMP-9, MMP-2, TIMP-1, and TIMP-2 in AEG and their correlation with clinicopathological parameters and the overall survival rate. METHODS: Expressions of MMP-9, MMP-2, TIMP-1, and TIMP-2 in specimens from 120 AEGs were detected by immunohistochemistry...
2016: OncoTargets and Therapy
John T Mullen, Eunice L Kwak, Theodore S Hong
The debate as to the optimal classification, staging, and treatment of gastroesophageal junction (GEJ) tumors wages on, and one must acknowledge that there is no "one-size-fits-all" approach. However, in this review we are charged with defending the position that all GEJ tumors are best treated like gastric cancer. We submit that, as stated, this is not a defensible position and that a clear definition of terms is warranted. Given the rarity of squamous cell carcinoma and the dramatic rise in incidence of adenocarcinoma of the GEJ in the West, we define GEJ "tumors" to mean adenocarcinomas of the GEJ...
November 2016: Annals of Surgical Oncology
Hirokazu Toshima, Atsushi Hisamatsu, Ken Shimada, Mitsuo Saito, Michitaka Suzuki, Masaaki Matsukawa, Haruhiro Inoue
A 60-year-old man was diagnosed with adenocarcinoma of the esophagogastric junction with lymph node metastasis along the left gastric artery. The clinical stage was determined to be T4b, N1, M0, Stage IIIB, and a neoadjuvant chemotherapy (NAC)regimen of capecitabine/CDDP plus trastuzumab was selected for treatment. Before 3 courses of chemotherapy, the patient developed perforated gastric cancer. With conservative therapy, we were able to obtain closure of the perforation without affecting the curability of the cancer...
June 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Paolo Aurello, Paolo Magistri, Giammauro Berardi, Niccolò Petrucciani, Dario Sirimarco, Laura Antolino, Giuseppe Nigri, Francesco D'Angelo, Giovanni Ramacciato
Esophageal carcinoma is the eighth most frequent cancer worldwide and the sixth cancer-related cause of death. Here we propose a new meta-analysis to identify the most appropriate approach for resectable adenocarcinoma of the distal esophagus and cardia (Siewert 1-2). A systematic literature search was performed independently by 2 of the manuscript's authors using PubMed, EMBASE, Scopus and the Cochrane Library Central. The following criteria were set for inclusion in this meta-analysis: 1) studies comparing transthoracic esophagectomy and transhiatal esophagectomy for adenocarcinoma of the esophagus; 2) studies reporting at least 1 perioperative outcome; and 3) if more than 1 study was reported by the same institute, only the most recent or the highest quality study was included...
August 3, 2016: Tumori
S P Mönig, L M Schiffmann
In the current German S3 guidelines surgical treatment is not recommended for metastatic gastric cancer or metastatic adenocarcinoma of the esophagogastric junction; however, in routine practice the indications can be extended so that there may be occasions in which radical surgical intervention for specific individuals may be appropriate as part of a multimodal therapy with curative intent. This article presents the scientific rationale of such an approach based on the available literature considering modern, multimodal therapy concepts including criteria to be met for radical surgery...
May 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Michela Roberto, Adriana Romiti, Concetta Elisa Onesti, Angelo Zullo, Rosa Falcone, Paolo Marchetti
Introduction and areas covered: We analysed the results of the main clinical studies looking at patients with advanced gastric or esophagogastric junction cancer, in order to differentiate between what is already clinical evidence and what is a promise for the cure of such patients. Thus, achievements from key studies, which had been purposely directed at chemotherapy, molecular target therapies and immunotherapy in both first and second-line setting were analysed. Metronomic chemotherapy, which consists of the administration of continuative low-dose anticancer drugs, was considered also...
July 2016: Expert Review of Anticancer Therapy
Eun Jeong Gong, Do Hoon Kim, Hoonsub So, Ji Yong Ahn, Kee Wook Jung, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) for adenocarcinoma in the esophagogastric junction (EGJ) is a technically difficult procedure. We analyzed the long-term clinical outcomes of ESD for adenocarcinoma in the EGJ to determine the feasibility of this treatment approach. METHODS: Subjects who underwent ESD for Siewert type II adenocarcinoma between December 2004 and December 2011 were eligible for this study. Clinical features and treatment outcomes were retrospectively reviewed using medical records...
September 2016: Digestive Diseases and Sciences
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