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UGI > EGJ Cancer > Flashcards

EGJ Cancer Flashcards

1
Q

Type I Siewert

A

1-5cm above EGJ

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2
Q

Type II Siewert

A

invading EGJ, with epicenter between 1cm above and 2cm below OGJ

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3
Q

Type III Siewert

A

invading EGJ, with epicenter 2-5cm below EGJ

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4
Q

R0 resection

A

proximal margin: take frozen section to confirm (5 cm may not be necessary)
distal margin: total gastrectomy

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5
Q

Dutch trial 2007

A

Type II/III tumors
Transthoracic with extended lymphadenectomy (RTA) vs transhiatal (TH)
Outcome:
-no 5 year overall survival benefit
-RTA increase pulmonary/chyle cx
-subgroup analysis. 5 year locoregional disease free survival better in RTA

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6
Q

Evidence in surgical options for type II/III: RTA (right thoracic approach in transthoracic) vs TH (transhiatal)

A

Dutch trial 2007

JCOG 9502

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7
Q

Evidence for chemoRT

A

CROSS
MAGIC
MRC OEO2

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8
Q

Classifications for EGJ

A

AJCC

Siewert

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9
Q

Surgical approaches for EGJ

1) Type 1
2) Type 2
3) Type 3

A

1) transthoracic 2-phase with 2FLND
2) controversial
3) transhiatal total gastrectomy + systemic lymphadenectomy

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UGI (8 decks)

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