胃食管结合部腺癌的诊治进展

The prognosis of gastroesophageal junction cancer is relatively poor given its special location and biological behavior. Surgery is the main treatment for adenocarcinoma of esophagogastric junction (AEG), but there is no consensus on the surgical method in different Siewert types. Based on the NCCN guideline and large-scale study results, this review believes that thoracogastroesophageal gastrectomy may benefit patients with Siewert Ⅰ type. In contrast, for patients with Siewert Ⅲ, partial or total gastrectomy is recommended. However, for Siewert Ⅱ patients, for surgical method we should consider tumor stage, tumor size, distance from the distal end to the junction of the stomach and esophagus, and other factors. No matter which surgical method is selected, R0 resection and thorough lymph node dissection are the most important factors affecting the prognosis. In addition, perioperative chemoradiotherapy or chemotherapy following surgery and adjuvant chemotherapy can benefit some patients at local regional advanced stage. For patients at advanced stage, targeted therapy and immunotherapy are an option of treatment.