[Carcinoma of the esophagus, esophagogastric junction, and stomach. Cooperation between pathology and surgery].
Cooperation between pathology and surgery plays a decisive role in the treatment of carcinoma of the esophagus, esophagogastric junction, and stomach. Preoperatively, the carcinoma is confirmed and the histologic type, grading, type of extension (stomach) and immunohistochemical or molecular-biological parameters, if necessary, are determined. For exclusion or diagnosis of distant metastases, peritoneal carcinosis, or secondary tumors, further biopsies or cytological examinations may be required. All results contribute to the individualized treatment. In case of endoscopic treatment, the completeness of resection of the carcinoma and the depth of infiltration must be identified with extraordinary diligence. Postoperative proof of tumor, location, histological type, completeness of resection and safety margin have to be identified. Detailed T-status, N-status with declaration of the ratio of affected and nonaffected number of lymph nodes, location of affected lymph nodes, extracapsular lymph node spread, invasion of lymphatic and vascular vessels and perineural sheets are important parameters. The description of tumor regression after neoadjuvant treatment (histomorphological response) is of special interest.
Klinik und Poliklinik für Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937 Köln. arnulf.hoelscher@uk-koeln.de
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Fetzner
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D004943:Esophagogastric Junction / Q000473:pathology* / Q000601:surgery; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D033183:Interdisciplinary Communication; D008207:Lymphatic Metastasis / Q000473:pathology; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery