Treatment of esophagogastric junction carcinoma: An unsolved debate

doi:10.3748/wjg.v21.i15.4427

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Apr 21, 2015; 21(15): 4427-4431
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4427

Treatment of esophagogastric junction carcinoma: An unsolved debate

Michele Orditura, Gennaro Galizia, Eva Lieto, Ferdinando De Vita, Fortunato Ciardiello

Michele Orditura, Ferdinando De Vita, Fortunato Ciardiello, Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, School of Medicine, Second University of Naples, 80131 Naples, Italy

Gennaro Galizia, Eva Lieto, Division of Surgical, Department of Anesthesiological, Surgical and Emergency Sciences, School of Medicine, Second University of Naples, 80131 Naples, Italy

Author contributions: All authors contributed equally to this work.

Correspondence to: Michele Orditura, MD, PhD, Division of Medical Oncology, Department of Internal and Experimental Medicine “F. Magrassi”, School of Medicine, Second University of Naples, c/o II Policlinico, Edificio 3, Via Pansini, 5, 80131 Naples, Italy. michele.orditura@unina2.it

Telephone: +39-815-666723 Fax: +39-815-666732

Received: November 13, 2014
Peer-review started: November 15, 2014
First decision: December 26, 2014
Revised: January 2, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: April 21, 2015
Processing time: 157 Days and 16 Hours

Abstract

The incidence of esophagogastric junction adenocarcinoma (AEG) is increasing worldwide. Barrett’s esophagus (BE) associated with dysplasia is the main risk factor for the development of cancer. Currently, screening programs to individuate and eradicate BE represent the best way to reduce AEG cancer. Several endoscopic approaches are here discussed. Surgical strategies for different types of AEG cancer are now fairly standardized, and multidisciplinary strategies using chemotherapy or chemoradiotherapy may improve the outcome of these patients. Here we briefly discuss the keypoints, main topics, and critical issues, according to accumulating evidence and taking into account our own experience.

Keywords: Barrett’s esophagus; Esophagogastric junction adenocarcinoma; Endoscopic resection; Surgery; Chemotherapy; Chemoradiotherapy

Core tip: Barrett’s esophagus (BE) associated with dysplasia is the main risk factor for the development of esophagogastric junction adenocarcinoma (AEG). Currently, screening programs to individuate and eradicate BE represent the best way to reduce AEG cancer. We aim to discuss several endoscopic approaches, surgical strategies for different types of AEG cancer, and multidisciplinary strategies using chemotherapy or chemoradiotherapy may improve the outcome of AEG patients.