| Although the incidence of esophagogastric junction (EGJ) tumors has gradually increased in recent years, the optimal extent of lymph node dissection for EGJ tumors has been unclear. Japanese gastric surgeons have traditionally performed open total gastrectomy and lower esophagectomy for EGJ tumors with esophageal involvement of less than 3 cm from the evidence of JCOG9502 trial (Lancet Oncol 2006). Recently, the Japanese Gastric Cancer Association and the Japan Esophageal Society have conducted a nationwide prospective study to elucidate the accurate incidence of lymph node metastasis from cT2-T4 EGJ tumors, and reported that total gastrectomy was not needed for EGJ tumors (Ann Surg 2020). In addition, subtotal esophagectomy with dissection of upper mediastinal station 106recR (right recurrent laryngeal nerve) was recommended if esophageal involvement exceeded 4 cm. Lower mediastinal station 110 (para-esophageal) should be dissected if esophageal involvement exceeded 2 cm. In this Symposium, we will show our recent procedure of minimally invasive surgery for EGJ tumors. |
