[Current status and prospects of surgical treatment for adenocarcinoma of the esophagogastric junction]

Abstract

Adenocarcinoma of the esophagogastric junction (AEG) has shown an increasing incidence in recent years. The treatment strategy for AEG differs from that of gastric and esophageal cancers due to its unique anatomical location and biological behavior. Surgical resection remains the cornerstone of AEG treatment, with the choice of surgical approach based on Siewert classification, esophageal invasion length, and individual patient factors. The extent of lymph node dissection is determined by tumor location, stage, and patterns of lymph node metastasis. Digestive tract reconstruction aims to maximize the preservation of digestive function and reduce postoperative complications while achieving radical tumor resection. In recent years, minimally invasive surgical techniques, including laparoscopic and robotic surgery, have been increasingly applied in AEG treatment, with preliminary validation of their safety and feasibility. Additionally, the application of neoadjuvant therapy, targeted therapy, and immunotherapy has brought new hope for AEG treatment. This article reviews the current status of surgical treatment for AEG, including surgical approaches, lymph node dissection, digestive tract reconstruction, and neoadjuvant therapy, and discusses future directions in AEG surgical treatment.