How do you treat locally advanced GE junction adenocarcinoma extending to the esophagus and cardia when the Siewert Type is indistinguishable between 2 and 3?

Topics: Radiation Oncology • Gastrointestinal Cancers

Considering a T2+ and/or N+ GE junction adeno, do you use neoadjuvant chemoradiation therapy or perioperative chemotherapy?

Does your treatment differ whether or not the patient is a surgical candidate?

Answer from: Radiation Oncologist at Academic Institution

There is no "correct" answer to this question as both relevant trials seemed to have improved outcomes with this type of disease, so either approach would be acceptable. However, I think one has to keep in mind that there are (at least) 2 factors that would drive a decision. One is biology an...

Comments

Radiation Oncologist at Toledo Clinic Inc.
Thank you, very informative.

Radiation Oncologist at Sunnybrook Health Sciences Centre
Absolutely agree with Dr. @Joel E. Tepper's inform...

Answer from: Radiation Oncologist at Academic Institution

When there is question about the epicenter of the tumor, it may be worthwhile to re-scope the patient, particularly if the original EGD was done at an outside institution and available images not informative. We have had many scenarios where a tumor was reported as esophageal/GE junction however, up...

Comments

Radiation Oncologist at Toledo Clinic Inc.
Thank you for your response.

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