Review
Copyright ©The Author(s) 2019.
World J Gastrointest Oncol. Aug 15, 2019; 11(8): 567-578
Published online Aug 15, 2019. doi: 10.4251/wjgo.v11.i8.567
Table 1 Different classification of esophagogastric junction cancer
SystemClassificationDescription
Siewert classificationType I1-5 cm above the EGJ
Type IIWithin 1 cm above and 2 cm below the EGJ
Type III2-5 cm below the EGJ
AJCC/UICC TNMEsophageal adenocarcinomasWithin 2 cm proximal or distal to the EGJ
Gastric cancerMore than 2 cm distal from the EGJ
Japanese classification-A tumor (≤ 4 cm diameter) with an epicenter locating within 2 cm of the EGJ, whether adenocarcinoma or squamous cell carcinoma
Table 2 Different approach for esophagogastric junction cancer
ApproachSurgical techniqueProcedureDisadvantage
RTIvor LewisMidline laparotomyLimited proximal margin
Requirement of body position change
Surgical stress is significant
MckeownRight thoracotomyIncreased risk for recurrent laryngeal nerve injury
Midline laparotomySurgical stress is significant
Left cervical
LTLTALeft thoracotomy extended to upper midline laparotomyNo middle or upper thoracic lymphadenectomy
Surgical stress is significant
Left thoracophrenolaparotomyTransdiaphragmatic thoracotomyNo middle or upper thoracic lymphadenectomy
Midline laparotomySurgical stress is significant
TH-Midline laparotomyLimited proximal margin
Left cervicalSurgical view of the lower mediastinum is poor
No middle or upper thoracic lymphadenectomy
TG-Midline laparotomyLimited proximal margin
No thoracic lymphadenectomy