J-L Van Laethem1, F Carneiro2, M Ducreux3, H Messman4, F Lordick5, D H Ilson6, W H Allum7, K Haustermans8, C Lepage9, T Matysiak-Budnik10, A Cats11, W Schmiegel12, A Cervantes13, E Van Cutsem14, Ph Rougier15, Th Seufferlein16. 1. Department of Gastroenterology, Gastrointestinal cancer unit, Erasme University Hospital, ULB, Brussels, Belgium. Electronic address: jl.vanlaethem@erasme.ulb.ac.be. 2. Department of Pathology, Centro Hospitalar São João/Medical Faculty & Ipatimup/Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal. 3. Department of Digestive Oncology, Institut G Roussy, Paris, France. 4. III. Medical Department, Clinic Augsburg, Augsburg, Germany. 5. University Cancer Center Leipzig (UCCL), University Medicine Leipzig, Leipzig, Germany. 6. Gastrointestinal cancer Division, Sloan memorial Kettering Hospital, New York, USA. 7. Department of Surgery, Royal Marsden NHS Foundation Trust, London, UK. 8. Radiation Oncology, University Hospitals Leuven, Department of Oncology, KU Leuven, Belgium. 9. Department of Hepato Gastroenterology and Digestive oncology, University hospital, Univ. Bourgogne Franche-Comté, LNC INSERM UMR866, Dijon, France. 10. IMAD, Hepato-Gastroenterology & Digestive Oncology, CHU de Nantes, France. 11. Department of Gastroenterology, Netherland Kanker Institute, Amsterdam, Netherlands. 12. Department of Gastroenterology,University Hospital, Bochum,Germany. 13. Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain. 14. Digestive Oncology, University Hospitals Leuven, KU Leuven, Belgium. 15. University Paris V René Descartes and University Hospital Hotel Dieu, Nantes, France. 16. Department of Internal Medicine I, Ulm University, Ulm, Germany.
Abstract
BACKGROUND AND SCOPE: The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. METHODOLOGY: Opinion leaders, selected on scientific merit were asked to answer to a prepared set of questions covering the approach of GOJ tumours from definition to therapeutic strategies. All answers were then discussed during a plenary session and reported here in providing a well-balanced reflection of both clinical expertise and updated evidence-based medicine. RESULTS: Definition, classification, diagnosis and staging of GOJ tumours were updated and debated. Therapeutic aspects including endoscopic therapy, surgical management, both multimodal curative and palliative management were also reviewed for proposing practical and consensual positions and recommendations whenever possible. CONCLUSION: GOJ tumours deserve specific attention,not only for uniformising clinical management across countries but also for performing specific clinical and translational research,mainly in the curative perioperative setting.
BACKGROUND AND SCOPE: The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. METHODOLOGY: Opinion leaders, selected on scientific merit were asked to answer to a prepared set of questions covering the approach of GOJ tumours from definition to therapeutic strategies. All answers were then discussed during a plenary session and reported here in providing a well-balanced reflection of both clinical expertise and updated evidence-based medicine. RESULTS: Definition, classification, diagnosis and staging of GOJ tumours were updated and debated. Therapeutic aspects including endoscopic therapy, surgical management, both multimodal curative and palliative management were also reviewed for proposing practical and consensual positions and recommendations whenever possible. CONCLUSION:GOJ tumours deserve specific attention,not only for uniformising clinical management across countries but also for performing specific clinical and translational research,mainly in the curative perioperative setting.
Authors: Fernando Mendoza-Moreno; M R Díez-Gago; J Mínguez-García; B Tallón-Iglesias; G Zarzosa-Hernández; S Fernández; M Solana-Maoño; J M Argüello-De-Andrés Journal: Niger J Surg Date: 2018 Jul-Dec