Clinicopathological features of Siewert type II adenocarcinoma: comparison of gastric cardia adenocarcinoma and Barrett’s esophageal adenocarcinoma following endoscopic submucosal dissection

Osumi, Hiroki; Fujisaki, Junko; Omae, Masami; Shimizu, Toshio; Yoshio, Toshiyuki; Ishiyama, Akiyoshi; Hirasawa, Toshiaki; Tsuchida, Takaaki; Yamamoto, Yorimasa; Kawachi, Hiroshi; Yamamoto, Norio; Igarashi, Masahiro

doi:10.1007/s10120-016-0653-x

Cited by 27 publications

(33 citation statements)

References 39 publications

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“…It is well known that differentiated mucosal cancer in early gastric cancer without lymphovascular involvement and ulceration exhibits almost no metastasis [12, 22]. Osumi et al [9] suggested that Barrett’s adenocarcinoma has a higher malignant potential but exhibits similar outcomes to gastric cardiac cancer. In addition, an improved 5-year survival rate was observed in ESD for Barrett’s adenocarcinoma than in ESD for squamous cell carcinoma (88.9 vs. 75.9%), though a statistical difference was not reported [23].…”

Section: Indication Of Esdmentioning

confidence: 99%

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

“…Barrett’s esophagus is defined as columnar epithelium that is replaced from stratified squamous epithelium of distal esophagus [1, 3, 13]. Two endoscopic findings of EGJ were reported: upper limit of the gastric fold and the end of the lower esophageal palisade vessels [9, 13]. Barrett’s adenocarcinoma is diagnosed when cancer is located on the oral side of EGJ because Barrett’s adenocarcinoma is defined as cancer arising from Barrett’s esophagus (Fig.…”

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

“…This classification includes not only adenocarcinoma but also squamous cell carcinoma [9, 13]. On the other hand, Siewert type II tumors, located 1 cm above and 2 cm below the EGJ, are considered true cardiac adenocarcinomas arising from the EGJ epithelium [2, 9, 11, 13]. Barrett’s esophagus is defined as columnar epithelium that is replaced from stratified squamous epithelium of distal esophagus [1, 3, 13].…”

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

“…Therefore, the following histological criteria are used to diagnose Barrett’s esophagus and Barrett’s adenocarcinoma after endoscopic resection, the presence of esophageal glands, duplication of the muscularis mucosae under the lesions, or a squamous island within the lesions according to the Japanese Classification of Esophageal Cancer (Fig. 1d–f) [7, 9, 11, 13]. Gastric cardiac adenocarcinoma was defined as cancer that did not have these characteristics (Fig.…”

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

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Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

et al. 2018

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Background: Adenocarcinoma of the esophagogastric junction (EGJ) is uncommon in Eastern countries, including Japan, but it is believed that the incidence of EGJ adenocarcinoma will increase in Asia in the future due to the decreasing incidence of Helicobacter pylori infection. Endoscopic submucosal dissection (ESD) is a minimally invasive and curative treatment that allows precise pathological assessment. Summary: Magnifying endoscopy with narrow-band imaging may be useful for differential diagnoses and for delineating the cancer margin of EGJ adenocarcinoma, but subsquamous carcinoma extension, which is the invasion of EGJ adenocarcinoma beneath the normal esophageal squamous epithelium, makes it difficult to detect cancer margins of the oral side in ESD for EGJ adenocarcinoma. Since subsquamous carcinoma extension was reported to be less than 1 cm in most cases, the oral safety margin that is placed 1 cm from the squamocolumnar junction is useful for negative cancerous horizontal margin. A multicenter retrospective study of esophageal adenocarcinoma including EGJ adenocarcinoma showed that mucosal and submucosal cancer within 500 μm from the muscularis mucosa without lymphovascular involvement, a poorly differentiated component, and lesion size over 3 cm were not associated with metastasis. Several retrospective studies about ESD for EGJ adenocarcinoma have suggested feasible short-term and long-term outcomes using curative criteria based on gastric cancer guidelines. Key Messages: ESD would be a good first-line treatment for superficial EGJ adenocarcinoma, including Barrett’s adenocarcinoma. Additional information about the incidence of metastasis would help confirm the indication of ESD for EGJ adenocarcinoma.

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Section: Indication Of Esdmentioning

confidence: 99%

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

Section: Definition Of Egj Adenocarcinoma and Barrett’s Adenocarcinomamentioning

confidence: 99%

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Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

et al. 2018

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Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

2018

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Endoscopic surveillance of Barrett's esophagus has become a foundation of the management of esophageal adenocarcinoma (EAC). Surveillance for Barrett's esophagus commonly involves periodic upper endoscopy with biopsies of suspicious areas and random four-quadrant biopsies. However, targeted biopsies using narrow-band imaging can detect more dysplastic areas and thus reduce the number of biopsies required. Several specific mucosal and vascular patterns characteristic of Barrett's esophagus have been described, but the proposed criteria are complex and diverse. Simpler classifications have recently been developed focusing on the differentiation between dysplasia and non-dysplasia. These include the Japan Esophageal Society classification, which defines regular and irregular patterns in terms of mucosal and vascular shapes. Cancer invasion depth is diagnosed by endoscopic ultrasonography (EUS); however, a meta-analysis of EUS staging of superficial EAC showed favorable pooled values for mucosal cancer staging, but unsatisfactory diagnostic results for EAC at the esophagogastric junction. Endoscopic resection has recently been suggested as a more accurate staging modality for superficial gastrointestinal cancers than EUS. Following endoscopic resection for gastrointestinal cancers, the risk of metastasis can be evaluated based on the histology of the resected specimen. European guidelines describe endoscopic resection as curative for well- or moderately differentiated mucosal cancers without lymphovascular invasion, and these criteria might be extended to lesions invading the submucosa (≤ 500 μm), i.e., to low-risk, well- or moderately differentiated tumors without lymphovascular involvement, and < 3 cm. These criteria were confirmed by a recent study in Japan.

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Evolving Role of Endoscopic Submucosal Dissection in the Management of Barrett’s Neoplasia

Radadiya

Desai

2023

Curr Treat Options Gastro

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Clinicopathological features of Siewert type II adenocarcinoma: comparison of gastric cardia adenocarcinoma and Barrett’s esophageal adenocarcinoma following endoscopic submucosal dissection

Abstract: Siewert type II adenocarcinoma encompasses two types of cancers with different etiologies: GCA and BEA. Although there are no significant differences in lifestyle-related background factors between GCA and BEA, BEA is a risk factor for noncurative resection via ESD.

Cited by 27 publications

References 39 publications

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

Endoscopic diagnosis and treatment of esophageal adenocarcinoma: introduction of Japan Esophageal Society classification of Barrett’s esophagus

Evolving Role of Endoscopic Submucosal Dissection in the Management of Barrett’s Neoplasia

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