[en] Surgery represents today the standard treatment of oesophageal and gastric cancer. Associated morbidity remain however significant in term of incisional access and functional sequels after organ resection and extended lymphadenectomy. Retrospective reviews of surgical series have defined indications for which more conservative treatment appears to provide similar survival without the need for lymph node resection. Endoscopic resection is now accepted for the treatment of well-differentiated tumors restricted to the mucosa. The expansion of this technique to deeper lesions or to lesions developed on a background of metaplasia is associated with an increased morbidity and significant risk of recurrence as well as a lifelong, close endoscopic surveillance. The role of surgery as primary treatment or rescue therapy to extend the resection will rely on an accurate preoperative and pathological staging of the lesion. Laparoscopy can play a central role in the management of early oesophageal and gastric cancer as it can permit from localized to extensive resection associated to lymph node dissection with the advantage of minimal invasive surgery. Its association to function-preserving operations awaits the demonstrated efficacy of targeted lymph node dissection. Those new techniques should be restricted to centres with extensive expertise and need to be validated in long-term controlled studies.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
De Roover, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Honore, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Language :
English
Title :
Early esophageal and gastric cancers: surgery in the era of minimally invasive treatment
Bozzetti, F., Principles of surgical radicality in the treatment of gastric cancer (2001) Surg. Oncol. Clin. N. Am., 10, pp. 833-854
Siewert, J.R., Fink, U., Sendler, A., Gastric cancer (1997) Curr Probl Surg, 34, pp. 835-939
Heitmiller, R.F., Redmond, M., Hamilton, S.R., Barrett's esophagus with high-grade dysplasia. An indication for prophylactic esophagectomy (1996) Ann. Surg., 224, pp. 66-71
Holscher, A.H., Bollschweiler, E., Schröder, W., Prognostic differences between early squamous-cell and adenocarcinoma of the esophagus (1997) Dis. Esophagus, 10, pp. 179-184
Headrick, J.R., Nichols, F.C., Miller, D.L., High grade esophageal dysplasia: Long-term survival and quality of life after esophagectomy (2002) Ann. Thor. Surg., 73, pp. 1697-1702
Tseng, E.E., Wu, T.T., Yeo, C.J., Barrett' esophagus with high-grade dysplasia: Surgical results and long-term outcome - An Update (2003) J. Gastrointestin. Surg., 7, pp. 164-170
Orringer, M.B., Marshall, B., Iannettoni, M.D., Transhiatal esophagectomy: Clinical experience and refinements (1999) Ann. Surg., 230, pp. 392-403
Kitagawa, Y., Kitano, S., Kubota, T., Minimally invasive surgery for gastric cancer - Toward a confluence of two major streams: A review (2005) Gastric Cancer, 8, pp. 103-110
Noh, S.H., Hyung, W.J., Cheong, J.H., Minimally invasive treatment for gastric cancer: Approaches and selection process (2005) J. Surg. Oncol., 90, pp. 188-194
(2002) Classification of Malignant Tumours, , UICC. International Union Against Cancer, TNM. Sobin LH, Wittekind C, (eds). New York: Wiley-Liss
Endo, M., Yoshino, K., Kawano, T., Clinicopathologic analysis of lymph node metastasis in surgically resected cancer of the thoracic esophagus (2000) Dis. Esophagus, 13, pp. 125-129
Wang, G., Jiao, G., Chang, F., Long term results of operation for 420 patients with early squamous cell esophageal carcinoma discovered by screening (2004) Ann. Thorac. Surg., 77, pp. 1740-1744
Van Sandick, J.W., Van Lanschot, J.J., Ten Kate, F.J., Pathology of early invasive adenocarcinoma of the esophagus or esophagogastric junction (2000) Cancer, 88, pp. 2429-2437
Gotoda, T., Yanagisawa, A., Sasako, M., Incidence of lymph node metastasis from early gastric cancer: Estimation with a large number of cases at two large centers (2000) Gastric Cancer, 3, pp. 219-225
Gotoda, T., Sasako, M., Ono, H., Evaluation of the necessity of gastrectomy with lymph node dissection for patients with submucosal invasive cancer (2001) Br. J. Surg., 88, pp. 444-449
Marelli, D., Roviello, F., De Manzoni, G., Different patterns of recurrence in gastric cancer depending on Lauren's histological type: Longitudinal study (2002) World J. Surg., 26, pp. 1160-1165
Roviello, F., Rossi, S., Marelli, D., Number of lymph node metastasis and its prognostic significance in early gastric cancer: A multicenter Italian study (2006) J. Surg. Oncol., 17, pp. 275-280
Abe, N., Watanabe, T., Sugiyama, M., Endoscopic treatment or surgery for undifferentiated early gastric cancer (2004) Am. J. Surg., 188, pp. 181-184
Ruol, A., Zaninotto, G., Costantini, M., Barrett's esophagus: Management of high-grade dysplasia and cancer (2004) J. Surg. Res., 117, pp. 44-51
Buttar, N.S., Wang, K.K., Sebo, T.J., Extent of high-grade dysplasia in Barrett's esophagus correlates with risk of adenocarcinoma (2001) Gastroenterology, 120, p. 1630
Ell, C., May, A., Gossner, L., Endoscopic mucosectomy of early adenocarcinoma in patients with Barrett's esophagus (1998) Gastroenterology, 114, pp. A589
Faybush, E.M., Sampliner, R.E., Randomized trials in the treatment of Barrett's esophagus (2005) Dis. Esophagus, 18, pp. 291-297
Bhandari, S., Shim, C.S., Kim, J.H., Usefulness of three-dimensional, multidetector row CT (virtual gastroscopy and multiplanar reconstruction) in the evaluation of gastric cancer: A comparison with conventional endoscopy, EUS and histopathology (2004) Gastrointest. Endosc., 59, pp. 619-626
Ziegler, K., Sanft, C., Zimmer, T., Comparison of computed tomography, endosonography, and intraoperative assessment in TN staging of gastric carcinoma (1993) Gut, 34, pp. 604-610
Tsendsuren, T., Jun, S.M., Mian, X.H., Usefulness of endoscopic ultrasonography in preoperative TNM staging of gastric cancer (2006) World J. Gastroenterol., 12, pp. 43-47
Murata, Y., Ohta, M., Hayashi, K., Preoperative evaluation of lymph node metastasis in esophageal cancer (2003) Ann. Thorac. Cardiovasc. Surg., 9, pp. 88-92
Ectors, N., Jouret, A., Editorial (2004) Acta Gastroenterol. Belg., 67, pp. 26-27
Ectors, N., Geboes, K., Histopathological reporting of resected carcinomas of the oesophagus and gastro-oesophageal junction (2004) Acta Gastroenterol. Belg., 67, pp. 28-32. , The Working Party for GI cancer
Nagy, N., Mathieu, A., Saal, I., Critical review in the surgical pathology of carcinoma of the stomach (2005) Acta Gastroenterol. Belg., 67, pp. 34-39. , The Working Party for GI Cancer
Jouret, A., Sempoux, C., Superficial oeso-gastric cancer and endoscopic mucosal resection: The pathologist's approach (2006) Acta Gastroenterol. Belg., 69, pp. 399-1303
Makuuchi, H., Endoscopic mucosal resection for mucosal cancer in the esophagus (2001) Gasirointest. Endosc. Clin. North Am., 11, pp. 445-458
Gotoda, T., Endoscopic resection of early gastric cancer: The Japanese perspective (2006) Curr. Opin. Gastroenterol., 22, pp. 561-569
Kodashima, S., Fujishiro, M., Yahagi, N., Endoscopic submucosal dissection for gastric neoplasia: Experience with the flex-knife (2006) Acta Gastroenterologica Belgica, 69, pp. 224-229
Ohwada, S., Nakamura, S., Ogawa, T., Segmental gastrectomy for early cancer in the mid-stomach (1999) Hepatogastroenterology, 46, pp. 1229-1233
Zhang, D., Shimoyama, S., Kaminishi, M., Feasibility of pylorus-preserving gastrectomy with a wider scope of lymphadenectomy (1998) Arch. Surg., 133, pp. 993-997
Tomita, R., A novel surgical procedure of vagal nerve, lower esophageal sphincter, and pyloric sphincter-preserving nearly total gastrectomy reconstructed by single jejunal interposition, and postoperative quality of life (2005) Hepatogastroenterology, 52, pp. 1895-1901
Adachi, Y., Inoue, T., Hagino, Y., Surgical results of proximal gastrectomy for early-stage gastric cancer: Jejunal interposition and gastric tube reconstruction (1999) Gastric Cancer, 2, pp. 40-45
Akiyama, H., Tsurumaru, M., Ono, Y., Esophagectomy without thoracotomy with vagal preservation (1994) J. Am. Coll. Surg., 178, pp. 83-85
Oh, D.S., Hagen, J.A., Chandrasoma, P.T., Clinical biology and surgical therapy of intramucosal adenocarcinoma of the esophagus (2006) J. Am. Coll. Surg., 203, pp. 152-161
Adachi, Y., Shiraishi, N., Shiromizu, A., Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy (2000) Arch. Surg., 135, pp. 806-810
Weber, K.J., Reyes, C.D., Gagner, M., Comparison of laparaoscopic and open gastrectomy for malignant disease (2003) Surg. Endosc., 17, pp. 968-971
Kitano, S., Yasuda, K., Shiraishi, N., Laparoscopic surgical resection for early gastric cancer (2006) Eur. J. Gastroenterol. Hepatol., 18, pp. 855-861
Otsuka, K., Murakami, M., Aoki, T., Minimally invasive tratment of stomach cancer (2005) Cancer J., 11, pp. 18-25
Nationwide survey on endoscopic surgery in Japan (2004) JJpn. Soc. Endosc. Surg., 9, pp. 475-569. , Japan Society for Endoscopic Surgery
(2004) Guidelines for the Treatment of Gastric Cancer, , The Japanese Gastric Cancer Association. Tokyo: Kanehara
Uyama, I., Sugioka, A., Fujita, J., Completely laparoscopic extragastric lymph node dissection for gastric malignancies located in the middle or lower third of the stomach (1999) Gastric Cancer, 2, pp. 186-190. , 30-32
Huscher, C.G., Mingoli, A., Sqarzini, G., Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: Five-year results of a randomized prospective trial (2005) Ann. Surg., 241, pp. 232-237
Akaishi, T., Kaneda, I., Higuchi, N., Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy (1996) J. Thorac. Cardiov. Surg., 112, pp. 1533-1540
Osugi, H., Takemura, M., Higashino, M., Learning curve of video-assisted thoracoscopic esophagectomy and extensive lymphadenectomy for squamous cell cancer of thoracic esophagus and results (2003) Surg. Endosc., 17, pp. 515-519
Smithers, B.M., Gotley, D.C., Mc Ewan, D., Thoracoscopic mobilization of the esophagus. A 6 year experience (2001) Surg. Endosc., 15, pp. 176-182
Luketich, J.D., Alvelo-Rivera, M., Buenaventura, P.O., Minimally invasive esophagectomy. Outcomes in 222 patients (2003) Ann. Surg., 238, pp. 486-495
Deprez, P., Aouattah, T., Piessevaux, H., Endoscopic removal or ablation of oesophageal and gastric superficial tumours (2006) Acta Gastroenterol Belg., 69, pp. 304-311