Multimodality treatment of cancer arising from Barrett's epithelium

Abstract

Adenocarcinoma arising in Barrett's epithelium is seen with increasing frequency. Most patients are diagnosed with advanced cancer, and the overall survival is less than 15%. Therefore novel preventive and therapeutic strategies are needed. Molecular markers are being developed that may predict which patients with Barrett's will develop cancer. Combined modality therapy with chemotherapy and surgery has been studied extensively in clinical trials. Although the results of these studies suggest improved survival, definitive proof must await completion of ongoing randomized trials. Surgical resection of adenocarcinoma provides restoration of swallowing and local tumor control with a low operative mortality.

3. Appropriateness of Gastroscopy: Barrett's Esophagus 1

“…In a retrospec tive series [36] of 30 consecutive patients who underwent esophagectomy for high-grade dysplasia, invasive adeno carcinoma was found in 43 %, thus favouring the most ag gressive option. Operative mortality rates for esophagec tomy range from 2-30% [32]; the overall 5-year actuarial survival rate for adenocarcinoma is 20% [37].…”