食道胃接合部腺癌の分類と外科治療
Despite substantial declines in gastric cancer incidence, the incidence of adenocarcinoma of the esophagogastricjunction (AEG) has been rising remarkably worldwide and is drawing considerable attention as well as concern.However, the optimal extent of esophagogastric resection for this tumor entity,...
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| Published in | 日大医学雑誌 Vol. 81; no. 5; pp. 247 - 253 |
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| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大学医学会
01.10.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0029-0424 1884-0779 |
| DOI | 10.4264/numa.81.5_247 |
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| Abstract | Despite substantial declines in gastric cancer incidence, the incidence of adenocarcinoma of the esophagogastricjunction (AEG) has been rising remarkably worldwide and is drawing considerable attention as well as concern.However, the optimal extent of esophagogastric resection for this tumor entity, especially Siewert type II tumorslocated at the true cardia, remains highly controversial. Given the uncertainty about the optimal extent of prophylactic lymph node dissection, both subtotal esophagectomy and extended total gastrectomy have been advocatedfor this tumor entity. A recent Japanese questionnaire-based national retrospective study showed that completenodal clearance along the distal portion of the stomach offered marginal survival benefits for patients with AEGless than 4 cm in diameter. A prospective nationwide multicenter study accurately identified the distribution oflymph node metastases from advanced AEG, suggesting that it is not recommended to completely dissect lymphnode stations along the distal portion of the stomach. Total gastrectomy might be employed less frequently andconsequently replaced by subtotal esophagectomy or extended proximal gastrectomy in clinical practice. |
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| AbstractList | Despite substantial declines in gastric cancer incidence, the incidence of adenocarcinoma of the esophagogastricjunction (AEG) has been rising remarkably worldwide and is drawing considerable attention as well as concern.However, the optimal extent of esophagogastric resection for this tumor entity, especially Siewert type II tumorslocated at the true cardia, remains highly controversial. Given the uncertainty about the optimal extent of prophylactic lymph node dissection, both subtotal esophagectomy and extended total gastrectomy have been advocatedfor this tumor entity. A recent Japanese questionnaire-based national retrospective study showed that completenodal clearance along the distal portion of the stomach offered marginal survival benefits for patients with AEGless than 4 cm in diameter. A prospective nationwide multicenter study accurately identified the distribution oflymph node metastases from advanced AEG, suggesting that it is not recommended to completely dissect lymphnode stations along the distal portion of the stomach. Total gastrectomy might be employed less frequently andconsequently replaced by subtotal esophagectomy or extended proximal gastrectomy in clinical practice. |
| Author | 山下, 裕玄 |
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| Copyright | 2022 日本大学医学会 |
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| DOI | 10.4264/numa.81.5_247 |
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| References | 3) Sasako M, Sano T, Yamamoto S, et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. The Lancet Oncology 2006; 7: 644–651. 8) Yamashita H, Katai H. Should adenocarcinoma of the es ophagogastric junction be classified as esophageal cancer? Limited to Siewert type II, yes. Annals of surgery 2015; 261: e67. 11) 岩田亮平，山下裕玄．多施設共同研究の結果からみる食道胃接合部癌治療戦略の展望．外科 2022; 84: 12–19. 14) 日本胃癌学会．胃癌治療ガイドライン 第6 版．金原出版株式会社，2021. 13) Kurokawa Y, Takeuchi H, Doki Y, et al. Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study. Annals of surgery 2021; 274: 120–127. 15) 日本食道学会．食道癌取扱い規約 第11 版．金原出版株式会社，2015. 6) Sobin LH, Gospodarowicz MK, Wittekind CH. TNM Classification of Malignant Tumours. 7th ed: Wiley-Blackwell; 2009. 1) Mariette C, Piessen G, Briez N, et al. Oesophagogastric junction adenocarcinoma: which therapeutic approach? The Lancet Oncology 2011; 12: 296–305. 4) Haverkamp L, Seesing MF, Ruurda JP, et al. Worldwide trends in surgical techniques in the treatment of esophageal and gas troesophageal junction cancer. Dis Esophagus 2017; 30: 1–7. 10) Sano T, Coit DG, Kim HH, et al. Proposal of a new stage grouping of gastric cancer for TNM classification: Internation al Gastric Cancer Association staging project. Gastric Cancer 2017; 20: 217–225. 7) Brierley JD, Gospodarowicz MK, Christian. W. TNM Classification of Malignant Tumours. 8th ed: Wiley-Blackwell; 2016. 5) Sobin L, Wittekind C. TNM Classification of Malignant Tumours. 6th ed: Wiley-Blackwell; 2002. 9) Yamashita H, Seto Y, Sano T, et al. Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma. Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2017; 20: 69–83. 2) Kusano C, Gotoda T, Khor CJ, et al. Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan. Journal of gastroenterology and hepatology 2008; 23: 1662–1665. 12) 日本胃癌学会．胃癌治療ガイドライン 第4 版．金原出版株式会社，2014. |
| References_xml | – reference: 14) 日本胃癌学会．胃癌治療ガイドライン 第6 版．金原出版株式会社，2021. – reference: 15) 日本食道学会．食道癌取扱い規約 第11 版．金原出版株式会社，2015. – reference: 3) Sasako M, Sano T, Yamamoto S, et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. The Lancet Oncology 2006; 7: 644–651. – reference: 6) Sobin LH, Gospodarowicz MK, Wittekind CH. TNM Classification of Malignant Tumours. 7th ed: Wiley-Blackwell; 2009. – reference: 10) Sano T, Coit DG, Kim HH, et al. Proposal of a new stage grouping of gastric cancer for TNM classification: Internation al Gastric Cancer Association staging project. Gastric Cancer 2017; 20: 217–225. – reference: 2) Kusano C, Gotoda T, Khor CJ, et al. Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan. Journal of gastroenterology and hepatology 2008; 23: 1662–1665. – reference: 9) Yamashita H, Seto Y, Sano T, et al. Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma. Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2017; 20: 69–83. – reference: 1) Mariette C, Piessen G, Briez N, et al. Oesophagogastric junction adenocarcinoma: which therapeutic approach? The Lancet Oncology 2011; 12: 296–305. – reference: 5) Sobin L, Wittekind C. TNM Classification of Malignant Tumours. 6th ed: Wiley-Blackwell; 2002. – reference: 11) 岩田亮平，山下裕玄．多施設共同研究の結果からみる食道胃接合部癌治療戦略の展望．外科 2022; 84: 12–19. – reference: 4) Haverkamp L, Seesing MF, Ruurda JP, et al. Worldwide trends in surgical techniques in the treatment of esophageal and gas troesophageal junction cancer. Dis Esophagus 2017; 30: 1–7. – reference: 7) Brierley JD, Gospodarowicz MK, Christian. W. TNM Classification of Malignant Tumours. 8th ed: Wiley-Blackwell; 2016. – reference: 8) Yamashita H, Katai H. Should adenocarcinoma of the es ophagogastric junction be classified as esophageal cancer? Limited to Siewert type II, yes. Annals of surgery 2015; 261: e67. – reference: 12) 日本胃癌学会．胃癌治療ガイドライン 第4 版．金原出版株式会社，2014. – reference: 13) Kurokawa Y, Takeuchi H, Doki Y, et al. Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study. Annals of surgery 2021; 274: 120–127. |
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| SubjectTerms | Siewert 分類 噴門側胃切除 西分類 食道亜全摘 食道胃接合部 |
| Title | 食道胃接合部腺癌の分類と外科治療 |
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