Diagnosis and treatment of gastric cancer and adenocarcinoma of the esophago-gastric junction

Gastric cancer and adenocarcinoma of the esophago-gastric junction are often reported together in clinical studies and guidelines despite their marked differences in carcinogenesis, tumor biology and treatment standards. However, distinguishing between different anatomical locations is crucial for appropriate local therapies. In the case of oncologic resection with systematic lymphadenectomy, lymphatic drainage pathways differ significantly and a number of different surgical approaches need to be considered. Tumor localization also plays an important role in radiotherapeutic treatment options. This article discusses the following topics in detail: pathogenesis and pathology, primary diagnosis and staging, curative surgical and endoscopic treatment, perioperative treatment, palliative systemic therapy, non-pharmacological supportive and palliative therapy.