Diagnostic Tests for Preoperative Staging of Esophagogastric Junction Tumors: Performance and Evidence-based Recommendations

Publication date: Available online 21 September 2019Source: Cirugía Española (English Edition)Author(s): Alexis Luna Aufroy, Salvador Navarro SotoAbstractPreoperative clinical staging is critical to select those patients whose disease is localized and may benefit from surgery with curative intent. Ideally, such staging should predict tumor invasion, lymphatic involvement and distant metastases. With the cTNM, we are able to select patients who could benefit from endoscopic resection, radical surgery or less radical treatment in patients with distant metastasis. The initial diagnosis of adenocarcinomas of the esophagogastric junction requires endoscopy with biopsies. For clinical staging, thoracoabdominal-pelvic CT scan, endoscopic ultrasound and PET or PET/CT are used. Other useful explorations are: barium swallow, endoscopic mucosal resection or endoscopic submucosal dissection (for assessment in initial stages) and staging laparoscopy. Once the resectability of the tumor has been established, the operability of the tumor should be assessed according to the patient's condition.ResumenLa estadificación clínica preoperatoria es crítica para seleccionar aquellos pacientes cuya enfermedad está localizada y se podrá beneficiar de una cirugía con intención curativa. Idealmente, dicha estadificación debería predecir la invasión tumoral, la afectación linfática y las metástasis a distancia. Con el cTNM podemos seleccionar aquellos pacientes a los que podremos ofrecer ...

Source: Cirugia Espanola - September 21, 2019 Category: Surgery Source Type: research