Controversies on the classification of esophagogastric junction carcinoma?a modified classi-fication based on esophageal invasion length
10.3760/cma.j.cn115610-20220704-00385
- VernacularTitle:食管胃结合部癌分型的思考与争议：基于食管浸润长度的改良分型
- Author:
Jiangfeng QIU
1
;
Xinli MA
Author Information
1. 上海交通大学医学院附属仁济医院胃肠外科，上海 200127
- Keywords:
Stomach neoplasms;
Esophagogastric junction carcinoma;
Siewert classi-fication;
Nishi classification;
Esophageal invasion length;
Modified classi-fication
- From:
Chinese Journal of Digestive Surgery
2022;21(8):1050-1055
- CountryChina
- Language:Chinese
-
Abstract:
Due to the particularity of tumor location, the surgery of esophagogastric junc-tion(EGJ) carcinoma needs to meet the safety of negative tumor margin, lymph node dissection and digestive tract reconstruction at the same time, which attracted more and more attention of esopha-gogastric surgeons. The current Siewert and Nishi classifications are based on the tumor epicenter, which is difficult to be accurately evaluated and measured before and during operation, and also lack of significance in determining the surgical methods and approach and lymph node dissection. The authors systematically analyze the limitations of Siewert and Nishi classification, discuss the relationship between esophageal invasion length and mediastinal lymph node metastasis and the role of esophageal invasion length on selection of surgical approach, and propose a modified classi-fication based on esophageal invasion length, including (1) malignant tumors with the upper or lower edge of tumor involving the zone of EGJ are defined as EGJ carcinoma; (2) EGJ carcinoma with the upper edge of tumor located 3.0 cm above the EGJ is classified as type Ⅰ; (3) EGJ carcinoma with the upper edge of tumor located 0?3.0 cm above the EGJ is classified as type Ⅱ; (4) EGJ carcinoma with the upper edge of tumor located 0?2.0 cm below the EGJ is classified as type Ⅲ.
