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Clinical Staging of Adenocarcinoma of the Esophagogastric Junction

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Adenocarcinoma of the Esophagogastric Junction

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 182))

Abstract

Tumors of the esophagogastric junction are among the most frequent and cause lethal cancers. Patients often do not present until late in the disease when the tumor is sufficiently large to cause obstruction or invasion of the adjacent structures, and thus becomes symptomatic. Preoperative staging is critical to select those patients whose disease is still locally confined for curative surgery. Ideally, clinical staging should accurately predict tumor invasion, lymph node involvement, and distant metastases. Upper endoscopy establishes the tumor diagnosis by multiple biopsies and defines the tumor type (Siewert I-III), based on tumor localization in relation to the endoscopic cardia. Preoperative TNM staging has a strong impact on treatment strategy. Endoscopic Ultrasound (EUS) determines the T category, and to a lesser extent, the presence of lymph node metastases. Multislice Computed Tomography (CT) and18 Fluorode­ocx­glucose Positron Emission Computed Tomography (18FDG-PET-CT) provide further information, especially about systemic metastases. Diagnostic laparascopy is suggested in advanced (CT3/4) Siewert type II-III tumors to exclude peritoneal carcinomatosis. This chapter summarizes current staging modalities and their accuracy in clinical practice.

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  1. Department of Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Paul M. Schneider

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  1. Julia Cordin
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  2. Kuno Lehmann
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  3. Paul M. Schneider
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Correspondence to Paul M. Schneider .

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  1. Klinik für Viszeral- und, Transplantationschirurgie, Universitätsspital Zürich, Rämistr. 100, Zürich, 8091, Switzerland

    Paul M. Schneider

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Cordin, J., Lehmann, K., Schneider, P.M. (2009). Clinical Staging of Adenocarcinoma of the Esophagogastric Junction. In: Schneider, P. (eds) Adenocarcinoma of the Esophagogastric Junction. Recent Results in Cancer Research, vol 182. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-70579-6_6

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  • DOI: https://doi.org/10.1007/978-3-540-70579-6_6

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