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Ways and tradition of Japan in esophageal surgery for cancer

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Abstract

Objective

This report presents the essence in practice of Japanese methods and tradition in surgery for esophageal cancer.

Methods

The etiology of esophageal cancer and the concepts of lymphadenectomy in esophagectomy, in neoadjuvant treatments, and in stage classifications are compared between Western countries and Japan.

Results

With respect to the type and relative incidence of esophageal cancer, in Western countries, adenocarcinoma in the lower thoracic esophagus and in the cardia is common, and among esophageal surgeons, there remains some controversy over the extent of lymphadenectomy. On the other hand, in Japan, squamous cell carcinoma in the middle thoracic esophagus is common, and concerning lymphadenectomy, Japanese esophageal surgeons consider that three-field lymphadenectomy is superior to other types of lymphadenectomy. In Japan, surgeons believe that most patients with esophageal cancer even those having lymph node metastasis can be best treated using esophagectomy and lymphadenectomy.

Conclusions

In Japan, the tradition in esophageal surgery places great significance on lymphadenectomy. The ways and procedures for esophageal cancer surgery, the neoadjuvant and adjuvant treatments, the Japanese Classification of Esophageal Cancer, the Esophageal Cancer Practice Guidelines, and other scientific reports are all based on a close combination of esophagectomy with lymphadenectomy.

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Fig. 1
Fig. 2

Modified from H Fujita, et al. World J Surg, 2003 (Reference 12)

Fig. 3

Modified from Fujita H. Surg Today, 2015 (Reference 20)

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Authors and Affiliations

  1. Department of Surgery, Shintakeo Hospital, Tomioka 12628, Takeo Town, Takeo, Saga, 843-0024, Japan

    Hiromasa Fujita

  2. Kurume University, Fukuoka, Japan

    Hiromasa Fujita

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  1. Hiromasa Fujita
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Correspondence to Hiromasa Fujita.

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Fujita, H. Ways and tradition of Japan in esophageal surgery for cancer. Gen Thorac Cardiovasc Surg 68, 1187–1192 (2020). https://doi.org/10.1007/s11748-020-01369-4

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  • DOI: https://doi.org/10.1007/s11748-020-01369-4

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