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Toihata et al. J Cancer Metastasis Treat 2018;4:24                  Journal of Cancer
               DOI: 10.20517/2394-4722.2017.82                           Metastasis and Treatment




               Review                                                                        Open Access


               Management of metastatic esophagogastric junction
               adenocarcinoma


               Tasuku Toihata , Yu Imamura , Masayuki Watanabe , Hideo Baba 1
                            1,2
                                         2
                                                            2
               1 Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto 860-0811,
               Japan.
               2 Gastroenterological Surgery, Cancer Institute Hospital, Tokyo 135-8550, Japan.
               Correspondence to: Dr. Masayuki Watanabe, Gastroenterological Surgery, Cancer Institute Hospital, Tokyo 135-8550, Japan.
               E-mail: masayuki.watanabe@jfcr.or.jp
               How to cite this article: Toihata T, Imamura Y, Watanabe M, Baba H. Management of metastatic esophagogastric junction
               adenocarcinoma. J Cancer Metastasis Treat 2018;4:24. http://dx.doi.org/10.20517/2394-4722.2017.82
               Received: 14 Dec 2017    First Decision: 18 Jan 2018    Revised: 4 Apr 2018    Accepted: 23 Apr 2018    Published: 17 May 2018

               Science Editors: Lucio Miele    Copy Editor: Jun-Yao Li    Production Editor: Huan-Liang Wu


               Abstract
               The prognosis of metastatic disease of esophagogastric junction adenocarcinoma remains poor, despite using a variety
               of regimens using cytotoxic agents. Recent understanding of molecular characteristic and tumor microenvironment
               of this cancer is currently instigating new therapeutic options. In this review, we summarized previous evidences of
               cytotoxic agents widely used worldwide, and updated recent developments of molecular targeted drugs, and immune
               checkpoint inhibitors.


               Keywords: Esophagogastric junction, adenocarcinoma, advanced, molecular targeted drug, immune checkpoint inhibitor,
               immunotherapy




               INTRODUCTION
               The esophagogastric junction (EGJ) adenocarcinoma is defined as tumors which have their center within 5 cm
                                                                     [1-3]
               proximal or distal to the anatomical esophagogastric junction . In Western countries, the incidence of
               EGJ adenocarcinoma has been increasing rapidly over the last few decades, in the background of decreasing
               rate of Helicobacter pylori infection, and increasing trends of obesity and gastroesophageal reflux disease
               (GERD). EGJ adenocarcinoma is usually diagnosed with unresectable disease because of difficulty in early
               detection. Even after curative resection, many cases experience recurrent disease, resulting in lower survival
                                [4,5]
               rates of this tumor . In spite of multidisciplinary treatments, median overall survival (OS) is around
                                                                [6,7]
               12 months in advanced EGJ or gastric adenocarcinoma . Therefore, the treatment goal for metastatic
                           © The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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