Background: The incidence of esophagogastric junction cancer (EGJC) is increasing in both Western and Eastern countries. Despite this trend, a globally accepted treatment strategy remains elusive due to the tumor’s anatomical complexity and variability in clinical practice. Aim: This review aims to provide a comprehensive overview of current evidence regarding EGJC treatment, focusing on the surgical approach, extent of lymph node dissection, and perioperative therapy. Special attention is given to regional differences and the implications of recent clinical trials. Findings: Transhiatal and minimally invasive surgical approaches have demonstrated favorable safety profiles, particularly for Siewert type II tumors. Lymph node dissection strategies are increasingly tailored based on the extent of esophageal invasion. Pre- and postoperative chemotherapy and chemoradiotherapy are standard in the West, while East Asian countries are gradually adopting these approaches through trials such as RESOLVE (China) and PRODIGY (Korea). Immunotherapy has also emerged as a promising option following the CheckMate 577 trial. Conclusions: EGJC requires individualized treatment planning based on tumor characteristics and regional practices. While ongoing trials continue to inform optimal management, international collaboration and a stepwise, biomarker-informed approach will be essential to harmonize treatment strategies for this anatomically and therapeutically complex disease.
背景：食管胃结合部癌（EGJC）的发病率在东西方国家均呈上升趋势。尽管发病率增长，但由于该肿瘤解剖结构的复杂性及临床实践的差异性，全球范围内尚未形成公认的治疗策略。目的：本综述旨在全面概述当前EGJC治疗的循证依据，重点关注手术入路、淋巴结清扫范围及围手术期治疗，并特别关注地区差异及近期临床试验的影响。研究发现：经食管裂孔入路和微创手术方式已显示出良好的安全性，尤其适用于Siewert II型肿瘤。淋巴结清扫策略正日益根据食管侵犯范围进行个体化制定。术前及术后化疗与放化疗在西方已成为标准方案，而东亚国家正通过RESOLVE（中国）和PRODIGY（韩国）等试验逐步采纳这些方案。随着CheckMate 577试验结果的公布，免疫治疗已成为前景广阔的新选择。结论：EGJC的治疗需根据肿瘤特征和地区实践进行个体化规划。尽管持续进行的临床试验不断为优化治疗方案提供依据，但针对这种解剖结构复杂、治疗难度高的疾病，国际协作及基于生物标志物的阶梯式诊疗策略，对于统一治疗标准至关重要。
An Overview of the Treatment Strategy of Esophagogastric Junction Cancer
肿瘤(癌症)患者之家