Diagnosis of Esophagogastric Junction Cancer - Retrospective Study

Esophagogastric junction cancer is a distinct anatomical and oncological entity with specific clinical and therapeutic characteristics. It is a pathology located at the interface between the esophagus and the stomach. It is classified according to the system proposed by Siewert into three types (I, II, III), depending on the location of the tumor center relative to the esophagogastric junction. From an anatomopathological point of view, esophagogastric junction cancer is an adenocarcinoma. The incidence of this type of neoplasm has been increasing in recent decades, especially in developed countries, and is associated with risk factors such as chronic gastroesophageal reflux, obesity, and Helicobacter pylori infection. The clinical diagnosis is based on the appearance of swallowing disorders, which at onset are represented by a feeling of retrosternal discomfort or a foreign body sensation, and in advanced stages by obstructive phenomena, manifested by dysphagia, which also associates general signs: asthenia, fatigue, weight loss. Occult or obvious bleeding may also occur, with secondary anemia. Paraclinically, upper digestive endoscopy assesses the tumor level and degree of obstruction, and biopsy sampling allows for histopathological typing, grading, and immunohistochemical and genetic testing. Computed tomography is still the most widely used investigation for diagnosis, pre-treatment TNM staging, assessment of neoadjuvant treatment efficacy, and detection of recurrence. In conclusion, the diagnosis of esophagogastric junction cancer involves a multimodal approach, which is essential for accurate staging and choice of therapeutic strategy.