, Volume 16, Issue 7, pp 2074-2075
Date: 14 Apr 2009

Progress and Limitations of Surgery in Improving Outcomes of Esophagogastric Junction Cancer

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TO THE EDITORS:

Adenocarcinoma of the esophagogastric junction (EGJ), also called gastric cardia cancer, has attracted major renewed interest from Western surgeons, oncologists, and physicians; statistics show a trend toward an increase in incidence of EGJ cancer, while distal stomach cancer rate is decreasing, prognosis still remains poor, surgeon volume and hospital volume may affect oncological outcomes, and treatment strategy regarding surgery and adjuvant treatment between cardia and noncardia gastric cancer differs.14

In a recent issue of the Annals of Surgical Oncology, Carboni and colleagues report on the surgical results of an abdominal-transhiatal approach of Italian patients with EGJ cancer.5 The authors conclude that abdominal-transhiatal approach for Siewert type II and III cardia adenocarcinoma is a safe surgical procedure enabling a complete resection (R0). Despite its strengths, this study has several weaknesses, on which we would like to comment.

Solid evidence from larg ...