Preoperative chemotherapy unmasks underlying Barrett’s mucosa in patients with adenocarcinoma of the distal esophagus

Theisen, Jörg; Stein, Hubert J.; Dittler, H. J.; Feith, Marcus; Moebius, Christian; Kauer, W. K. H.; Werner, Martin; Siewert, J. R.

doi:10.1007/s00464-001-8307-3

Cited by 60 publications

(39 citation statements)

References 18 publications

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“…A retrospective study reviewed 79 patients with locally advanced EAC who had preoperative chemotherapy and had restaging endoscopy and biopsy prior to resection. Pretherapy endoscopy showed BE in 75%, whereas 97% had documented BE on post-chemotherapy biopsy or in the resected specimen (13). This suggests that the cancer overgrows the fertile field of BE so that at presentation of the patient with EAC, BE may no longer be detectable.…”

Section: Barrett's Esophagus Is a Change In The Distal Esophageal Epimentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,277

893

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PREAMBLEThe guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review. Significant advances have occurred in the area of Barrett's esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett's esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett's esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach. Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett's esophagus, as defined herein.Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett's esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and any additional ones found in reference to these papers were obtained and reviewed. Evidence was available from a hierarchy of trials and randomized controlled trials were given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations are based on expert opinion. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), Grade B indicates that the evidence would be level 2 or 3 which are cohort studies or case control studies. Grade C recommendations are based on level 4 studies meaning case series or poor quality cohort studies, and Grade D recommendations are based on level 5 evidence meaning expert opinion.

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Section: Barrett's Esophagus Is a Change In The Distal Esophageal Epimentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,277

893

View full text Add to dashboard Cite

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“…It is unknown if all oesophageal adenocarcinomas arise from Barrett' s oesophagus but there is some evidence to suggest that this is the case [7] . In surveillance programs of Barrett' s oesophagus only a minority of patients develop oesophageal adenocarcinoma [8][9][10][11][12] raising the question of what factors are implicated in the development of oesophageal adenocarcinoma from Barrett's oesophagus.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for Barrett’s oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study

Anderson¹,

Watson

Murphy

et al. 2007

WJG

220

226

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AIM:To investigate risk factors associated with Barrett's oesophagus and oesophageal adenocarcinoma. METHODS:This all-Ireland population-based casecontrol study recruited 224 Barrett's oesophagus patients, 227 oesophageal adenocarcinoma patients and 260 controls. All participants underwent a structured interview with information obtained about potential lifestyle and environmental risk factors. RESULTS: CONCLUSION:A high body mass index, a diet low in fruit and cigarette smoking may be involved in the progression from Barrett's oesophagus to oesophageal adenocarcinoma.

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“…From the histological viewpoint, BE includes a combination of three types of columnar epithelia described by Chandrasoma et al as cardiac, oxyntocardiac, and intestinal [2]. Among these types, intestinal metaplastic mucosa, namely specialized intestinal mucosa (SIM), has been conventionally accepted as the only neoplastic precursor of esophageal adenocarcinoma (EAC) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

Watari

Oshima

Fukui

et al. 2013

Clin J Gastroenterol

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Barrett's esophagus (BE) is a premalignant condition of esophageal adenocarcinoma (EAC). Although the incidence of BE has risen rapidly in the West, it is rare in Asia despite a recent increase in the prevalence of gastroesophageal reflux disease. Controversies over the definition of BE are presented because most cases show shortsegment BE, especially ultra-short BE, in Asia. Here we review possible risk factors for the development of EAC, particularly possible roles of ethnicity, specialized intestinal metaplasia (SIM), BE length, and environmental factors, such as Helicobacter pylori infection and obesity. Additionally, we summarize recent studies on the effect of chemoprevention including proton pump inhibitors, nonsteroidal anti-inflammatory drugs or aspirin in order to reduce the risk of neoplastic progression in BE patients. Although substantial knowledge of risk factors of dysplasia/EAC in BE is shown, the risk for neoplastic development may be influenced by geographic variation, study population, the presence or absence of SIM or dysplasia at baseline, and the small number of BE patients investigated. Recently, the efficiency of surveillance for BE patients has been discussed from the standpoint of cost-effectiveness. It may be too difficult to draw conclusions because no randomized clinical trials of BE surveillance have been performed.

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Preoperative chemotherapy unmasks underlying Barrett’s mucosa in patients with adenocarcinoma of the distal esophagus

Abstract: Underlying Barrett's mucosa is frequently masked by tumor overgrowth in patients with locally advanced adenocarcinoma of the distal esophagus.

Cited by 60 publications

References 18 publications

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Risk factors for Barrett’s oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

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