OnCo
termsTerm

Gastro-oesophageal junction (GEJ)

aka GEJ, GOJ, gastroesophageal junction, gastro-oesophageal junction, oesophagogastric junction, junctional, Siewert

Where the food pipe meets the stomach. Cancers here are classed by how far above or below the junction they centre (Siewert I-III), which decides whether they are treated like oesophageal or stomach cancer.

Adenocarcinoma of the GEJ has risen sharply in Western countries with obesity and reflux (via Barrett's oesophagus). Siewert type I (mainly oesophageal) is treated with chemoradiation (CROSS) and oesophagectomy; type III (mainly gastric) with perioperative FLOT and extended gastrectomy; type II either way. Drug trials for HER2, PD-L1 and claudin 18.2 usually enrol gastric and GEJ tumours together, so the label 'gastric or GEJ adenocarcinoma' is common on approvals.

Category
Anatomy

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