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Surgical approach to advanced Siewert II cancer: beyond the borders? The West Side
Arnulf H Hölscher1, Elfriede Bollschweiler2, Ulrich K Fetzner3
1Center for Esophagogastric Cancer Surgery, St. Elisabethen Hospital Frankfurt, Ginnheimer Str. 3, 60487, Frankfurt, Germany. arnulf.hoelscher@icloud.com.
Abstract:
The surgical approach to Siewert type II cancer should be individualized as there is no "one size fits all" option. Criteria for individualization are epidemiological, functional, oncologic and surgical items. However, our preferred procedure for advanced adenocarcinoma of the esophagogastric junction type II is esophagectomy, if this or transhiatal extended gastrectomy are both possible with R0 resection. Esophagectomy has the advantages of a longer esophageal safety margin, complete mediastinal lymphadenectomy, easier anastomosis, routine minimal invasive gastrolysis with abdominal lymphadenectomy and preservation of a gastric reservoir.
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