Two Updates on Oesophagogastric Junction Adenocarcinoma from the Fifth WHO Classification of Tumors of the Digestive System: Alteration of Definition and Emphasis on HER2 Test.

Abstract

Background: The incidence of oesophagogastric junction adenocarcinoma has increased rapidly but remains controversial over the last decades. There are two crucial updates of the fifth World Health Organization(WHO) classification, including the alteration of its definition and the emphasize on human epidermal growth factor receptor 2 (HER2) test.Methods: A total of 566 clinicopathological samples from patients who were diagnosed with gastric adenocarcinoma were retrospectively analyzed. We comprehensively compared the clinicopathological features of oesophagogastric junction adenocarcinoma between fourth (V4.0) and fifth (V5.0) WHO version. The clinicalpathological features among oesophagogastric junction, proximal and distal gastric tumors with fourth and fifth edition were also compared, respectively. Besides, we discussed the correlation of the HER2-expression with clinicopathological features according to the V5.0. Results: The results showed that the difference was mainly between oesophagogastric junction and distal adenocarcinoma in V4.0, while some were found between proximal and distal adenocarcinoma in V5.0. Tumors invading oesophagus more than 3cm were still mainly oesophagogastric junction tumors. The expression of HER2 in oesophagogastric junction and proximal gastric adenocarcinoma was still higher than that in gastric body and distal site.Conclusions: The clinicopathological parameters of the oesophagogastric junction tumors changed to some extent in the updated WHO version. The proximal gastric tumors tended to be more invasive, rather than that located in oesophagogastric junction. But the latter with oesophageal invasion required additional management. The HER2-expression of oesophagogastric junction adenocarcinoma is the highest. The classification of the V5.0 is reasonable and worth a recommendation.

The relationship between PD-L1 expression and clinicopathological characteristics and prognosis of Vietnamese gastric cancer patients

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Quality of life comparison between esophagogastrostomy and double tract reconstruction for proximal gastrectomy assessed by Postgastrectomy Syndrome Assessment Scale (PGSAS)‐45

“… 8 In such situations there is an increase in the rate of the upper gastric cancer. 9 Proximal gastrectomy has been a frequent treatment approach for early upper third gastric cancer. Various reconstruction methods have been used for proximal gastrectomy.…”

“…In Japan, the incidence of gastric cancer has decreased due to the decrease in the rate of H. pylori infection and the spread of H. pylori infection detection/eradication treatment in health checkups 8 . In such situations there is an increase in the rate of the upper gastric cancer 9 . Proximal gastrectomy has been a frequent treatment approach for early upper third gastric cancer.…”

Gross tumor volume of adenocarcinoma of esophagogastric junction corresponding to cT and cN stages measured with computed tomography to quantitatively determine resectabiliy: A case control study

“…In 1998, Siewert classified AEG into three types, including type I with the tumor center 1–5 cm above the esophagogastric junction, type II with the tumor center located between 1 cm above and 2 cm below the junction, and type III with the tumor center 2–5 cm below the junction. This classification has been adopted by the International Gastric Cancer Society and by the International Society for Disease of the Esophagus, and helped clarify that different approaches are needed for the different types of cancer ( 2 , 4 ).…”