CARCINOMAS INVOLVING THE ESOPHAGOGASTRIC JUNCTION (EGJ-CA) - A REEVALUATION OF THE CRITERIA

The present study aims to elucidate more clearly the definition and cr iteria for carcinomas involving the esophagogastric junction (EGJ-Ca) from a practical viewpoint based on the concept that an EGJ-Ca is a se parate surgical disease entity different from either a lower-esophagea l or an upper-gastric carcinoma. Among a series of 397 cases of upper- gastric carcinoma and EGJ-Ca resected during a 31-year period between 1963 and 1993, 79 patients with EGJ-Ca (EGJ-Index ranging between 250 and 750) were selected according to lesions with the central point con fined within the EGJ-zone 20 mm each proximal and distal to the EGJ-li ne. Selected for the control group were 97 patients with upper-gastric carcinoma that was strictly confined within the upper third segment o f the stomach without involving the EGJ-line upward or the middle thir d segment downward and with the central point of lesions outside the E GJ-zone. The comparative analysis indicated that an EGJ-Ca might be we ll defined not only by the EGJ-Index, but also by the EGJ-zone and the localization of the central points of lesions confined within the EGJ -zone, The definition and criteria for EGJ-Ca were thus modified from those of the previous proposal and proposed in this study with three m ain factors: (1) the EGJ-Index, (2) the EGJ-zone, and (3) the localiza tion of the central point of lesions.