Both methods provide important staging information regarding the spread of the lesions, either by lymphatogenous or by direct invasion. Metastatic lesions are candidates for pallative therapy, either resection or bypass, and possible chemotherapy. Locally advanced lesions are considered for neoadjuvant therapy with restaging and consideration for resection. Resectable adenocarcinoms, those that do not penetrate the gastric wall, are candidates for currative resection. Extension into the right chest via thoracotomy is sometimes needed for complete mobilization of the distal esophagus.
Consideration is given for placment of a feeding jejunostomy.
I and II lesions followed by chemotherapy. If tumor regression is seen, then resection is indicated. Current Surgical Therapy.-6th ed. All rights reserved.