Processing of Surgical Specimen (Esophagogastrectomy) for Esophageal Adenocarcinoma

  • Benjamin M. Allanson
  • M. Priyanthi Kumarasinghe
Part of the Methods in Molecular Biology book series (MIMB, volume 1756)


An esophagogastrectomy is a surgical procedure that is performed for treatment of confirmed localized esophageal and esophagogastric junction adenocarcinoma. Proper macroscopic assessment and cut-up technique is essential to ensure that the overall assessment is correct and reproducible. Here, we describe a standard for macroscopic assessment and dissection to be used for routine handling of esophagogastrectomy specimens in the clinical laboratory.

Key words

Esophageal adenocarcinoma Macroscopic Handling Cut up Esophagogastrectomy Esophagectomy 


  1. 1.
    Mapstone NP (2007) Dataset for the histopathological reporting of esophageal carcinoma. The Royal College of Pathologists, LondonGoogle Scholar
  2. 2.
    Lester S (2010) Manual of surgical pathology. Saunders Elsevier, PhiladelphiaGoogle Scholar
  3. 3.
    Ibrahim N (2000) Guidelines for handling esophageal biopsies and resection specimens and their reporting. J Clin Pathol 53:89–94CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kumarasinghe MP, Brown IS, Charlton A, De Boer B, Eckstein R, Epari K, Gill A, Lam A, Lauwers G, Raftopoulos S, Price T (2013) Tumours of the esophagus and gastro-esophageal junction structured reported protocol, 1st edn, Published on web by Royal College of Pathologists of Australasia.
  5. 5.
    Lagarde S, ten Kate F, Reitsma J, Busch O, van Lanschot J (2006) Prognostic factors in adenocarcinoma of the esophagus or gastresophageal junction. J Clin Oncol 24:4347–4355CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Griffiths E, Brummell Z, Gorthi G, Pritchard S, Welch I (2006) Tumor length as a prognostic factor in esophageal malignancy: univariate and multivariate survival analyses. J Surg Oncol 93:258–267CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Eloubeidi M, Desmond R, Arguedas M, Reed C, Wilcox C (2009) Prognostic factors for the survival of patients with esophageal carcinoma in the U.S.: the importance of tumor length and lymph node status. Cancer 95:1434–1443CrossRefGoogle Scholar
  8. 8.
    Deeter M, Dorer R, Kuppusamy M, Koehler R, Low D (2009) Assessment of criteria and clinical significance of circumferential resection margins in esophageal cancer. Arch Surg 144:618–624CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Dexter S, Sue-Ling H, MCMahan M, Quirke P, Mapstone N, Martin I (2001) Circumferential resection margin involvement: an independent predictor of survival following surgery for esophageal cancer. Gut 48:667–670CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Chang F, Deere H, Mahadeva U, George S (2008) Histopathologic examination and reporting of esophageal carcinomas following preoperative neoadjuvant therapy: practical guidelines and current issues. Am J Clin Pathol 129:252–262CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Aida J, Vieth M, Ell C, May A, Pech O, Hoshihara Y, Kumagai Y, Kawada K, Hishima T, Taitishi Y, Sawabe M, Arai T, Matsuura M, Takubo K (2011) Palisade vessels as a new histologic marker of esophageal origin in ER specimens from columnar-lined esophagus. Am J Surg Pathol 35:1140–1145CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Amin M, Edge S, Greene F, Byrd D, Brookland R, Washington M, Gershenwald J, Compton C, Hess K, Sullivan D, Jessup J, Brierley J, Gaspar L, Schilsky R, Balch C, Winchester D, Asare E, Madera M, Gress D, Meyer L (eds) (2017) AJCC cancer staging manual, 8th edn. Springer, New YorkGoogle Scholar
  13. 13.
    Allanson BM, Bonavita J, Mirzai B, Khor T, Raftopoulos S, de Boer WB, Brown IS, Kumarasinghe MP (2017) Early Barrett esophagus-related neoplasia in segments 1cm or longer is always associated with intestinal metaplasia. Mod Pathol 30:1170–1176CrossRefPubMedGoogle Scholar
  14. 14.
    Rice T, Rusch V, Ishwaran H, Blackstone E (2010) Cancer of the esophagus and esophagogastric junction. Data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Cancer Staging Manuals. Cancer 116:3763–3773CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2018

Authors and Affiliations

  • Benjamin M. Allanson
    • 1
  • M. Priyanthi Kumarasinghe
    • 2
    • 3
  1. 1.Department of Tissue Pathology and Diagnostic OncologyRoyal Prince Alfred HospitalCamperdownAustralia
  2. 2.PathWest Laboratory MedicineQueen Elizabeth II Medical CentreNedlandsAustralia
  3. 3.School of Pathology and Laboratory MedicineUniversity of Western AustraliaCrawleyAustralia

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