However, Siewert type II tumor is a metastatic threat to both thoracic and abdominal areas, as it crosses the EGJ. Subtotal esophagectomy offers only a limited benefit and should not be performed for type II cancer. The TNM staging system according to the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC)
Cancer Staging Manual defined EGJC, including of squamous-cell carcinoma and adenocarcinoma centered this website in the esophagus within 5 cm, and in the proximal 5 cm of the stomach with crossing the EGJ [6, 7]. AJCC/UICC also Entospletinib categorizes any cardiac cancer without EGJ invasion as gastric cancer regardless of its location. Different staging systems are applied to esophageal squamous-cell carcinoma and esophageal adenocarcinoma. Surgery is effective treatment for resectable esophageal [8, 9] and gastric cancer [10–12]. However, as esophagectomy is generally more invasive than gastrectomy [13], we should be careful
in treating EGJC with esophagectomy. We studied clinicopathological characteristics CHIR98014 mouse of patients with EGJC to investigate its optimal management. Methods Study design We performed a single center, retrospective cohort study. We studied patients who underwent curative surgery for EGJC, including lymph node dissection, at the Digestive Disease Center, Showa University Northern Yokohama Hospital, between October 2001 and December 2010. Clinicopathological data and prognosis were taken from medical records. Patients We studied patients with cancer in the lower esophagus and cardia. Inclusion criteria were: (i) presence of histologically proven carcinoma centered within the lower 5 cm of the esophagus and the upper 5 cm of the stomach; (ii) clinically solitary tumors; (iii) no prior endoscopic resection or surgical treatment; and (iv) patient aged 20–80 years. The exclusion criteria were: (i) presence of severe organ dysfunction;
(ii) presence of metachronous and synchronous malignancy; selleck compound and (iii) presence of pathological non-curative findings. All patient data were approved for use by the institutional review board of Showa University Northern Yokohama Hospital. This study was registered with the University Hospital Medical Information Network in Japan (No. UMIN000008596). Classification Although Siewert classification is one of the most widely used criteria for EGJC, it is generally used for only adenocarcinoma. EGJC, including squamous cell carcinoma, has been defined by the seventh edition of AJCC/UICC TNM Cancer Staging Manual. However, it does not cover all of the cancer near the EGJ—for example a localized gastric adenocarcinoma with centered in the stomach within 5 cm from EGJ. Thus, we categorized tumors near the EGJ into four types, according to location and main histological type (Figure 1).