Results of the different surgical options for the treatment of cancer of the esophagogastric junction: Review of the evidence. / Resultados de las diferentes opciones quirúrgicas para el tratamiento del cáncer de la unión esofagogástrica. Revisión de la evidencia.

There is significant controversy in the management of cardiac cancer. It seems unanimous that Siewert type I tumors be operated on as cancer of the esophagus and Siewert type III as gastric cancer. However, for "true" cancer of the gastric cardia or Siewert II, the authors do not agree. There is the obvious need for free proximal and distal margins, as well as correct lymphadenectomy. For some, esophagectomy is necessary to perform correct radical oncological surgery, but other authors defend that an abdominal approach is sufficient to perform total gastrectomy and distal esophagectomy. Recent and older papers published do not clarify this issue, and their results are contradictory. Chemotherapy prior to surgery can reduce the size of the tumor and the presence of lymphadenopathies.

Carcinoma de la unión esofagogástrica: una mirada a un terreno difícil: [revisión] / Gastroesophageal junction carcinoma: an overview to a difficult terrain: [review]

Justificación. En el mundo occidental ha disminuido el carcinoma gástrico. El carcinoma de la unión gastroesofágica presenta una incidencia en aumento, y una aparente falta de estudio. Objetivo. Revisar los datos actualizados en relación al Carcinoma de la unión gastroesofágica, con el fi n de estimular un mayor estudio al respecto. Materiales y métodos. Se realizó una búsqueda, en la base de datos de MEDLINE, entre los años 1990 y 2006, con base en Cochrane Reviews Manual. Se utilizaron los términos Esophagogastric junction Carcinoma. De los artículos obtenidos inicialmente, fueron seleccionados los más relevantes por su actualidad. Conclusiones: la clasifi cación de Siewert es fundamental para el tratamiento del carcinoma de la unión gastroesofágica. La quimioterapia y radioterapia adyuvantes son una buena opción para disminuir la tasa de recaídas y mejorar pronóstico. Aún faltan estudios que indiquen el tamizaje y que profundicen en los parámetros adecuados para el tratamiento del CUEG.

Justification. In the western world the gastric carcinoma has decreased. The gastroesophageal junction carcinoma shows an arising incidence, and an apparent lack in its study. Objective. To revise the actualized data regarding the Gastroesophageal junction carcinoma. Materials and methods. A research was made, through the MEDLINE database, between the years 1990 to 2006, with base in the Cochrane Reviews Manual. The terms used were Esophagogastric junction carcinoma. Of the initially obtained articles, the most relevant were selected because their actuality. Conclusions. The Siwert’s classification is fundamental of the treatment of the Gastroesophageal junction. The adjuvant chemotherapy plus radiotherapy is a good choice to improve the overall and relapse-free survival. There are still not enough studies that indicate the screening and all the parameters to determine the treatment of Gastroesophageal junction carcinoma.