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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
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