FCS(SA) Final Practice Questions - Fellowship Of The College Of Surgeons Of South Africa Final Examination FCS(SA) Final Exam

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A 62-year-old male presents with dysphagia to solid foods and unintentional weight loss. Endoscopy reveals an adenocarcinoma extending from 1 cm above to 2 cm below the oesophagogastric junction (Siewert Type II). Staging CT and PET show T3N1M0 disease. What is the most appropriate definitive management strategy?

Primary endoscopic mucosal resection followed by oral proton pump inhibitor therapy Neoadjuvant chemoradiotherapy followed by transthoracic or transhiatal subtotal oesophagectomy with proximal gastrectomy Immediate total gastrectomy with Roux-en-Y reconstruction without neoadjuvant therapy Definitive chemoradiotherapy alone without surgical resection

Correct Answer:

Neoadjuvant chemoradiotherapy followed by transthoracic or transhiatal subtotal oesophagectomy with proximal gastrectomy

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