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Adenokarzinom des gastroösophagealen Übergangs (AEG-Karzinom), sog. Kardiakarzinom

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Praxis der Viszeralchirurgie Onkologische Chirurgie

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Zusammenfassung

Gemäß internationaler Übereinkunft werden die Adenokarzinome des gastroösophagealen Übergangs, in Kurzform auch als AEG bezeichnet, als eigene Entität verstanden (Stein et al. 2000). Diese allgemein akzeptierte Auffassung wird durch epidemiologische Untersuchungen gestützt, die einheitlich eine kontinuierliche Zunahme der Inzidenz der AEG zeigen (Cameron et al. 1995; DeMeester u. DeMeester 2000; Devesa et al. 1998; . Abb. 39.1), es scheinen also Gemeinsamkeiten in der Onkogenese dieses Tumortyps zu bestehen (DeMeester u. DeMeester 2000; Wijnhoven et al. 1999). Klar ist auch, dass die AEG nicht mit dem Plattenepithelkarzinom der Speiseröhre oder mit dem typischen Magenkarzinom des mittleren und distalen Drittels verglichen werden können (Siewert et al. 1987; Siewert u. Stein 1996). Dennoch umfasst der Begriff AEG bei allen Gemeinsamkeiten verschiedene Tumorsubgruppen, die tumorbiologisch und damit auch prognostisch unterschiedlich zu sehen sind. Unter diesen Gesichtspunkten, aber auch, um Literaturergebnisse miteinander besser vergleichen zu können und adäquate therapeutische Konsequenzen ziehen zu können, ist eine Klassifikation der AEG wünschenswert (Fein et al. 1998; Husemann 1989; Kodera et al. 1999; Siewert et al. 1987; Siewert u. Stein 1996, 1998).

Trends der Inzidenz für das Adenokarzinom des Magens bei US-amerikanischen männlichen Patienten, differenziert nach ethnischer Zugehörigkeit und anatomischer Lokalisation, 1974–1976 und 1992–1994. (Nach Devesa et al. 1998)

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Literatur

  • Aikou T, Shimazu H (1989) Difference in main lymphatic pathways from the lower esophagus and gastric cardia. Jpn J Surg 19: 290–295

    Article  CAS  PubMed  Google Scholar 

  • Barbour AP, Lagergreen P, Hughes R, Alderson D, Barham, CP, Blazeby JM (2008) Health-related quality of life among patients with adenocarcinoma of the gastro-oesophageal junction treated by gastrectomy or oesophagectomy. Br J Surg 95:80–84

    Article  CAS  PubMed  Google Scholar 

  • Bumm R, Feussner H, Bartels H, Stein HJ, Dittler HJ, Höfler H, Siewert JR (1997) Radical transhiatal esophagectomy with two-field lymphadenectomy and endodissection for distal esophageal adenocarcinoma. World J Surg 21: 822–831

    CAS  PubMed  Google Scholar 

  • Cameron AJ, Lomboy CT, Pera M, Carpenter HA (1995) Adenocarcinoma of the esophagogastric junction and Barrett’ esophagus. Gastroenterology 109: 1541–1546

    Article  CAS  PubMed  Google Scholar 

  • Clark GW, Smyrk TC, Burdiles P et al. (1994) Is Barrett’s metaplasia the source of adenocarcinomas of the cardia? Arch Surg 129: 609–614

    CAS  PubMed  Google Scholar 

  • DeMeester SR, DeMeester TR (2000) Columnar mucosa and intestinal metaplasia of the esophagus. Fifty years of controversy. Ann Surg 231: 303–321

    Article  CAS  PubMed  Google Scholar 

  • Chandrasoma C, Wickramasinghe K, Ma Y, DeMeester T (2007) Adenocarcinomas of the Distal Esophagus and »Gastric Cardia« Are Predominantly Esophageal Carcinomas. Am J Surg Pathol 31:569–575

    Article  PubMed  Google Scholar 

  • Devesa SS, Blot WJ, Fraumeni JF Jr (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83: 2049–2053

    Article  CAS  PubMed  Google Scholar 

  • Ellis FH Jr, Heatley GJ, Krasna MJ, Williamson WA, Balogh K (1998) Esophagogastrectomy for carcinoma of the esophagus and cardia. A comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria. J Thorac Cardiovasc Surg 113: 836–846

    Google Scholar 

  • Fein M, Fuchs KH, Ritter MP, Freys SM, Heimbucher J, Staab C, Thiede A (1998) Application of the new classification for cancer of the cardia. Surgery 124: 707–713

    Article  CAS  PubMed  Google Scholar 

  • Flejou JF, Muzeau F, Potet F, Lepelletier F, Fekete F, Henin D (1994) Overexpression of the p53 tumor suppressor gene product in esophageal and gastric carcinomas. Pathol Res Pract 190: 1141–1148

    CAS  PubMed  Google Scholar 

  • Fleming ID, American Joint Committee on Cancer Classification/AJCC (eds) (2002) AJCC cancer staging manual. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  • Goldfaden D, Orringer MB, Appelman HD, Kalish R (1986) Adenocarcinoma of the distal esophagus and gastric cardia. Comparison of results of transhiatal esophagectomy and thoracoabdominal esophagogastrectomy. J Thorac Cardiovasc Surg 91: 242–247

    CAS  PubMed  Google Scholar 

  • Graham AJ, Finley RJ, Clifton JC, Evans KG, Fradet G (1998) Surgical management of adenocarcinoma of the cardia. Am J Surg 175: 418–421

    Article  CAS  PubMed  Google Scholar 

  • Harrison LE, Karpeh MS, Brennan MF (1997) Proximal gastric cancers resected via a transabdominal-only approach. Results and comparisons to distal adenocarcinoma of the stomach. Ann Surg 225: 678–683

    Article  CAS  PubMed  Google Scholar 

  • Hsu CP, Wu CC, Chen CY, Hsu NY, Jiun YH, Wang PY (1997) Clinical experience in radical lymphadenectomy for adenocarcinoma of the gastric cardia. J Thorac Cardiovasc Surg 114: 544–551

    Article  CAS  PubMed  Google Scholar 

  • Hulscher JB, van Sandick JW, de Boer AG et al. (2002) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347: 1662–1669

    Article  PubMed  Google Scholar 

  • Husemann B (1989) Cardia carcinoma considered as a distinct clinical entity. Br J Surg 76: 136–139

    Article  CAS  PubMed  Google Scholar 

  • Ireland AP, Shibata DK, Chandrasoma P, Lord RV, Peters JH, DeMeester TR (2000) Clinical significance of p53 mutations in adenocarcinoma of the esophagus and cardia. Ann Surg 231: 179–187

    Article  CAS  PubMed  Google Scholar 

  • Kajiyama Y, Tsurumaru M, Udagawa H, Tsutsumi K, Kinoshita Y, Ueno M, Akiyama H (1997) Prognostic factors in adenocarcinoma of the gastric cardia: Pathologic stage analysis and multivariate regression analysis. J Clin Oncol 15: 2015–2021

    CAS  PubMed  Google Scholar 

  • Kodera Y, Yamamura Y, Shimizu Y et al. (1999) Adenocarcinoma of the gastroesophageal junction in Japan: Relevance of Siewert’s classification applied to 177 cases resected at a single institution. J Am Coll Surg 189: 594–601

    Article  CAS  PubMed  Google Scholar 

  • Lagergren J, Bergström R, Lindgren A, Nyren O (1999) Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 340: 825–831

    Article  CAS  PubMed  Google Scholar 

  • Laurén P (1965) The two histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma. Acta Pathol Microbiol Scan 64: 31–49

    Google Scholar 

  • Lordick, F, Ruers T, Aust DE et al. (2008) European Organisation of Research and Treatment of Cancer (EORTC) Gastrointestinal Group: Workshop on the role of metabolic imaging in the neoadjuvant treatment of gastrointestinal cancer. Eur J Cancer 44:1807–1819

    Article  PubMed  Google Scholar 

  • Lordick F, Ott K, Krause BJ et al. (2007) PET to assess early metabolic response and to guide traetment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase II trial. Lancet Oncol 8:797–805

    Article  PubMed  Google Scholar 

  • Mueller J, Stein HJ, Ouyang T, Natsugoe S, Feith M, Werner M, Siewert JR (2000) Frequency and clinical impact of lymph node micrometastases and tumor cell microinvolvement in adenocarcinoma of the esophagogastric junction. Cancer 89: 1874–1882

    Article  CAS  PubMed  Google Scholar 

  • Omloo JM, Lagarde SM, Hulscher JB et al. (2007) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg 246(6):992–1000

    Article  PubMed  Google Scholar 

  • Ott K, Weber W, Fink U et al. (2003) Fluorodeoxyglucose-PET in adenocarcinoma of the distal esophagus and cardia. World J Surg 27: 1035–1039

    Article  PubMed  Google Scholar 

  • Papachristou DN, Fortner JG (1980) Adenocarcinoma of the gastric cardia. The choice of gastrectomy. Ann Surg 192: 58–64

    Article  CAS  PubMed  Google Scholar 

  • Parshad R, Singh RK, Kumar A, Gupta SD, Chattopadhyay TK (1999) Adenocarcinoma of distal esophagus and gastroesophageal junction: Longterm results of surgical treatment in a North Indian Center. World J Surg 23: 277–283

    Article  CAS  PubMed  Google Scholar 

  • Sarbia M, Borchard F, Hengels KJ (1993) Histogenetical investigations on adenocarcinomas of the esophagogastric junction. An immunhistochemical study. Pathol Res Pract 189: 530–535

    CAS  PubMed  Google Scholar 

  • Schneider PM, Schweighart P, Stöltzing O et al. (1997) Molecular evidence that cancer of the cardia is different from Barrett’s cancer and related to proximal third gastric cancer. 2nd International Gastric Cancer Congress 1997; Book of abstracts, p 6

    Google Scholar 

  • Siewert JR, Stein HJ (1996) Adenocarcinoma of the gastroesophageal junction: Classification, pathology and extent of resection. Dis Esoph 9: 173–182

    Google Scholar 

  • Siewert JR, Stein HJ (1998) Classification of carcinoma of the oesophagogastric junction. Br J Surg 85: 1457–1459

    Article  CAS  PubMed  Google Scholar 

  • Siewert JR, Hölscher AH, Becker K, Gössner W (1987) Kardiakarzinom: Versuch einer therapeutisch relevanten Klassifikation. Chirurg 58: 25–34

    CAS  PubMed  Google Scholar 

  • Siewert JR, Stein HJ, Sendler A, Fink U (1999) Surgical resection for cancer of the cardia. Semin Surg Oncol 17: 125–131

    Article  CAS  PubMed  Google Scholar 

  • Siewert JR, Feith M, Werner M, Stein HJ (2000) Adenocarcinoma of the esophago-gastric junction: results of surgical therapy based on anatomic-topographic classification in 1002 consecutive patients. Ann Surg 232: 353–361

    Article  Google Scholar 

  • Siewert JR, Fink U, Sendler A et al. (1997) Gastric cancer. Curr Probl Surg 34: 835–942

    Article  CAS  PubMed  Google Scholar 

  • Siewert JR, Stein HJ, Feith M (2003) Surgical approach to invasive adenocarcinoma of the distal esophagus (Barrett’s cancer). World J Surg 27: 1058–1061

    Article  PubMed  Google Scholar 

  • Siewert JR, Bartels H, Stein HJ (2005) Abdominorechtsthorakale Ösophagoektomie mit intrathorakaler Anastomose beim Barrett-Karzinom. Chirurg 76:588–594

    Article  CAS  PubMed  Google Scholar 

  • Siewert JR, Lordick F, Ott K et al. (2007) Induction chemotherapy in Barrett cancer: influence on surgical risk and outcome. Ann Surg 246:624–628

    Article  PubMed  Google Scholar 

  • Sobin LH, Wittekind C, International Union Against Cancer (UICC) (eds) (2002) TNM Classification of malignant tumors. John Wiley & Sons, New York

    Google Scholar 

  • Stahl M, Walz MK, Stutschke M et al. (2009) Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol 27:851–856

    Article  CAS  PubMed  Google Scholar 

  • Stark SP, Romberg MS, Pierce GE et al. (1996) Transhiatal versus transthoracic esophagectomy for adenocarcinoma of the distal esophagus and cardia. Am J Surg 172: 478–481

    Article  CAS  PubMed  Google Scholar 

  • Stein HJ, Feith M, Mueller J, Werner M, Siewert JR (2000) Limited resection for early adenocarcinoma of the Barrett’s esophagus. Ann Surg 232: 733–742

    Article  CAS  PubMed  Google Scholar 

  • Stein HJ, von Rahden BHA, Höfler H, Siewert JR (2003) Karzinom des ösophagogastralen Übergangs und Barrett Ösophagus-ein nahezu klares onkologisches Modell? Chirurg 74: 703–708

    Article  CAS  PubMed  Google Scholar 

  • Stein HJ, Zacherl J, Feith M, Siewert J R (2004) Chirurgie des Adenokarzinoms des gastro-ösophagealen Übergangs. In: Meyer H-J, Buhr HJ, Wilke H (Hrsg) Management des Ösophagus-und Magenkarzinoms. Springer, Berlin Heidelberg New York Tokio, pp 223–230

    Google Scholar 

  • Stein HJ, Feith M, Siewert JR (2009) Neoadjuvante Therapie im oberen Gastrointestinaltrakt. Chirurg 11:1019–1022

    Article  Google Scholar 

  • Steup WH, De Leyn P, Deneffe G, van Raemdonck D, Coosemans W, Lerut T (1996) Tumors of the esophagogastric junction. Longterm survival in relation to the pattern of lymph node metastasis and a critical analysis of the accuracy or inaccuracy of the pTNM classification. J Thorac Cardiovasc Surg 111: 85–94

    Article  CAS  PubMed  Google Scholar 

  • Tachimori Y, Kato H, Watanabe H, Sasako M, Konoshita T, Maruyama K (1996) Difference between carcinoma of the lower esophagus and the cardia. World J Surg 20: 507–510

    Article  CAS  PubMed  Google Scholar 

  • Walsh TN, Noonan N, Hollywood D et al. (1996) A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med 335: 462–467

    Article  CAS  PubMed  Google Scholar 

  • Wayman J, Dresner SM, Raimes SA, Griffin SM (1999) Transhiatal approach to total gastrectomy for adenocarcinoma of the gastric cardia. Br J Surg 86: 536–540

    Article  CAS  PubMed  Google Scholar 

  • Wijnhoven BP, Siersema PD, Hop WC, van Dekken H, Tilanus HW (1999) Adenocarcinomas of the distal oesophagus and gastric cardia are one clinical entity. Rotterdam Oesophageal Tumour Study Group. Br J Surg 86: 529–535

    Article  CAS  PubMed  Google Scholar 

  • Yonemura Y, Tsugawa K, Fonseca L et al. (1995) Lymph node metastasis and surgical management of gastric cancer invading the esophagus. Hepatogastroenterology 42: 37–42

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Universitätsklinikum Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg

    Prof. Dr. med. Dr. h.c. J. R. Siewert (Leitender Ärztlicher Direktor und Vorstandsvorsitzender)

  2. Chirurgische Klinik, Klinikum Nürnberg-Nord, Ernst-Nathan-Straße 1/Haus 20, 90419, Nürnberg

    Univ.-Prof. Dr. med. H. J. Stein

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  1. Prof. Dr. med. Dr. h.c. J. R. Siewert
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  2. Univ.-Prof. Dr. med. H. J. Stein
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Editors and Affiliations

  1. Universitätsklinikum Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg

    J. R. Siewert (Leitender Ärztlicher Direktor und Vorstandsvorsitzender) (Leitender Ärztlicher Direktor und Vorstandsvorsitzender)

  2. Zentrum für Operative Medizin I, Klinikum der Philipps-Universität, Baldinger Straße, 35043, Marburg

    Matthias Rothmund

  3. Universitätsklinik und Poliklinik, Medizinische Fakultät der RWTH, Pauwelsstraße 30, 52057, Aachen

    Volker Schumpelick

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Siewert, J.R., Stein, H.J. (2010). Adenokarzinom des gastroösophagealen Übergangs (AEG-Karzinom), sog. Kardiakarzinom. In: Siewert, J.R., Rothmund, M., Schumpelick, V. (eds) Praxis der Viszeralchirurgie Onkologische Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03808-2_39

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