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Optimal Extent of Lymph Node Dissection for Esophagogastric Junction Carcinoma in Japan: Newly Developed Algorithm and Perspective Hiroharu Yamashita 1 , Shinya Kodashima 2 , Mitsuhiro Fujishiro 2 , Yasuyuki Seto 1 1Department of Gastrointestinal Surgery, Graduate School of Medicine, the University of Tokyo, Tokyo 2Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo Keyword: 食道胃接合部癌 , リンパ節郭清アルゴリズム , 下部食道噴門側胃切除 , 食道亜全摘 , 胃全摘 pp.1161-1167
Published Date 2015/8/25
DOI https://doi.org/10.11477/mf.1403200387
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 EGJ(Esophagogastric junction)carcinoma, representing carcinoma involving the anatomical border between the esophagus and the stomach, has recently attracted considerable attention. In patients with cancer of the true cardia, comparable outcomes have been obtained by extended esophagectomy and total gastrectomy;however, the optimal surgical approach remains to be clarified. A nationwide survey with a large cohort elucidated the lymph node spread pattern of true cardiac carcinomas 4cm or less in diameter. Nodal metastases were frequent in the pericardial nodes(No.1 and No.2), the lesser curvature node(No.3), along the left gastric artery node(No.7), followed by the lower mediastinal paraesophageal node(No.110)and the suprapancreatic nodes(No.8a, 9, 11p). Nodes along the distal stomach were rarely involved;therefore, total gastrectomy may not be justified for prophylactic lymphadenectomy for true cardiac cancer 4cm or less in diameter.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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