Cancers of the gastro-esophageal junction are tumors developed at the junction between the esophagus and the stomach . There are of three types (according to Siewert´s classification) which are classified according to their location.
Symptoms and diagnosis of cancer of the gastro-esophageal junction
The predominant symptoms of cancer of the gastro-esophageal junction are dysphagia , or inability to ingest food, and unexplained weight loss.
The diagnosis of cancer of the gastro-esophageal junction and the determination of the type of tumor require various examinations, such as gastroscopy with biopsies, endoscopy , CT scan of the thorax and the abdomen, as well as a PET-scan in some cases. A surgical exploration by diagnostic laparoscopy may also be necessary.
Surgical treatment of cancer of the gastro-esophageal junction
The treatment strategy is discussed during the tumor board . When tumor removal is possible, surgery is the treatment of choice. Neoadjuvant chemotherapy prior to surgery with or without neoadjuvant radiotherapy can be proposed.
The type of cancer determines the type of intervention:
- For type 1 tumors, total esophagectomy is proposed.
- Type 2 tumors are usually treated like type 1 tumors.
- For type 3 tumors, total gastrectomy with removal of the distal part of the esophagus is recommended.
Post-operative chemotherapy may be recommended.
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