Based on a Lecture at the American College of Surgeons Meeting Oct 2003.
Biologic and clinical variations of adenocarcinoma at the esophago–gastric junction: Relevance of a topographic-anatomic subclassification†
Article first published online: 13 MAY 2005
Copyright © 2004 Wiley-Liss, Inc.
Journal of Surgical Oncology
Special Issue: Seminars in Surgical Oncology: Gastric Cancer
Volume 90, Issue 3, pages 139–146, 1 June 2005
How to Cite
Siewert, J. R., Feith, M. and Stein, H. J. (2005), Biologic and clinical variations of adenocarcinoma at the esophago–gastric junction: Relevance of a topographic-anatomic subclassification. J. Surg. Oncol., 90: 139–146. doi: 10.1002/jso.20218
- Issue published online: 13 MAY 2005
- Article first published online: 13 MAY 2005
- esophageal cancer;
- gastric cancer;
- cardia cancer;
- esophago–gastric junction;
A topographic-anatomic subclassification of adenocarcinomas of the esophago–gastric junction (AEG) in distal esophageal adenocarcinoma (AEG Type I), true carcinoma of the cardia (AEG Type II), and subcardial gastric cancer (AEG Type III) was introduced in 1987 and is now increasingly accepted and used worldwide. Our experience with now more than 1,300 resected AEG tumors indicates that the subtypes differ markedly in terms of surgical epidemiology, histogenesis and histomorphologic tumor characteristics. While underlying specialized intestinal metaplasia can be found in basically all patients with AEG Type I tumors, this is uncommon in Type II tumors and virtually absent in Type III tumors. Stage distribution and overall long-term survival after surgical resection also shows marked differences between the AEG subtypes. Surgical treatment strategies based on tumor type allow a differentiated approach and result in survival rates superior to those reported with other approaches. The subclassification of AEG tumors thus provides a useful tool for the selection of the surgical procedure and allows a better comparison of treatment results. J. Surg. Oncol. 2005;90:139–146. © 2005 Wiley-Liss, Inc.