Extent of lymphadenectomy for Barrett’s cancer
| Autor: | Claudia Ly Wong, Simon Law |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry medicine.medical_treatment General surgery Gastroenterology Cancer Review Article Disease medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Esophagectomy 030220 oncology & carcinogenesis medicine Adenocarcinoma 030211 gastroenterology & hepatology Lymphadenectomy Esophagogastric junction Esophagus business R0 resection |
| Zdroj: | Translational Gastroenterology and Hepatology. 4:36-36 |
| ISSN: | 2415-1289 |
| DOI: | 10.21037/tgh.2019.05.07 |
| Popis: | Adenocarcinoma of the esophagus and esophagogastric junction (EGJ) has become the predominant histological cell type in western countries due to the prevalence of obesity, gastroesophageal reflux disease and Barrett's esophagus. There is some evidence that this is increasing in the East as well. Surgery aims at achieving an R0 resection with clear margins, together with adequate and appropriate lymphadenectomy. Siewert type I and II cancers are more likely to be associated with Barrett's esophagus (especially in western countries), while type III cancers are mostly proximal gastric cancers that have grown upwards to involve the EGJ. For type I cancers, most surgeons would perform an esophagectomy, with at least an infra-carinal lymphadenectomy. It is more controversial for type II tumors, with some surgeons preferring an esophagectomy, while others may opt for a proximal or total radical gastrectomy via an abdominal approach. All procedures can be performed using open or minimally invasive methods. In addition to oncologic reasons, the chosen surgical approach also depends on expertise available, safety issues, and postoperative quality-of-life considerations. More data are needed in this area. How to integrate knowledge and also multimodality treatment strategies is an active area of research. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|