Adenocarcinoma of the esophagogastric junction

Adenocarcinoma of the esophagogastric junction (EGJ) has increased rapidly in incidence in the latter half of the twentieth century. The increase in i ncidence has affected white men between the ages of 40 and 60 disproportion ately. Understanding the etiology and improving treatment requires careful classification of EGJ tumors. A recent consensus conference recognized thre e types of EGJ adenocarcinomas: distal esophageal, cardia, and subcardia ga stric. Distal esophageal adenocarcinomas are associated with Barrett's esop hagus, Heilcobacter pylori infection may play a role in some adenocarcinoma s of the subcardia, but the association is unproven. Therapy for all types of EGJ tumors is surgical, but multimodal forms of treatment are commonly u sed because of the advanced stage at which these tumors often present. Seve ral endoscopic options exist for primary therapy of early-stage tumors and for palliation.