| Strategic International Session3（S）(JSGS・JSGE・JGES) |
| Fri. November 1st 14:00 - 17:00 Room 11: Portopia Hotel South Wing Topaz |
| Multidisciplinary treatment for esophagogastric junction cancer from a Dutch perspective | |||
| Suzanne Sarah Gisbertz | |||
| Amsterdam UMC | |||
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| In the Netherlands, the incidence of esophageal cancer is one of the highest in the world, which is attributable to the rise in the incidence in adenocarcinoma. These are usually distal esophageal cancers or gastro-esophageal junction cancers. For junction cancers the neoadjuvante treatment depends on the involvement of the stomach. If significant involvement of the stomach is observed, the preferred treatment is perioperative FLOT. Otherwise chemoradiation in administered, although things may change with the results of the resent ESOPEC trial. Surgical treatment is usually an Ivor Lewis esophagectomy. This is executed minimally invasively (MIE or RAMIE). For bulky tumors or with significant stomach involvement, also a left thoraco-abdominal approach is frequently being performed. Both a total gastrectomy + distal esophagectomy with high Roux-Y anastomosis and a cardia resection + distal esophagectomy with gastric tube reconstruction can be performed via this approach. Lymphadenectomy is 2-field in case of Ivor Lewis esophagectomy. In left thoracoabdominal, subcarinal nodes are included. Laparoscopic total gastrectomy is performed if very limited esophageal involvement is present. Then distal para-esophageal nodes are included in the resection. |
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Index Term 1: Esophegectomy Index Term 2: Lymphadenectomy |
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