Evidence Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Mar 24, 2022; 13(3): 159-167
Published online Mar 24, 2022. doi: 10.5306/wjco.v13.i3.159
Evidence-based approach to the treatment of esophagogastric junction tumors
Francisco Schlottmann, María A Casas, Daniela Molena
Francisco Schlottmann, María A Casas, Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires C1118AAT, Argentina
Daniela Molena, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Author contributions: Schlottmann F, Casas MA, and Molena D contributed to conception and design, acquisition of data, drafting of the article, and final approval of the version to be published.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francisco Schlottmann, MD, Surgeon, Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredón 1640, Buenos Aires C1118AAT, Argentina. fschlottmann@hotmail.com
Received: April 4, 2021
Peer-review started: April 4, 2021
First decision: June 4, 2021
Revised: June 14, 2021
Accepted: February 15, 2022
Article in press: February 15, 2022
Published online: March 24, 2022
Processing time: 353 Days and 10.4 Hours

The incidence of esophagogastric junction (EGJ) adenocarcinoma is increasing in developed nations due to the rising prevalence of obesity and gastroesophageal reflux disease. Due to the peculiar location in a histological transition zone between the esophagus and the stomach, the management of EGJ tumors is controversial. Two main surgical approaches exist: total gastrectomy with distal esophagectomy or esophagectomy by either transhiatal or transthoracic approach. These operations differ significantly in the extent of lymphadenectomy. In addition, patients with locally advanced disease can receive either preoperative chemoradiation or perioperative chemotherapy. This evidence-based review analyzes current evidence regarding the management of EGJ tumors in order to help defining the best surgical and systemic treatment of these patients.

Keywords: Esophagogastric junction tumors, Esophagectomy, Gastrectomy, Esophageal adenocarcinoma, Chemotherapy, Chemoradiation

Core Tip: Management of patients with esophagogastric junction tumors is challenging. Several surgical approaches and systemic therapies are currently available to treat these patients. This evidence-based review will help determining the optimal treatment for this complex disease.