Adenocarcinoma of the esophagus and Barrett's esophagus: a population-based study

Bytzer, Peter; Christensen, Peer Brehm; Damkier, Per; Vinding, Kirsten; Seersholm, Niels

doi:10.1016/s0002-9270(98)00657-1

Cited by 76 publications

(78 citation statements)

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“…[7][8][9] This increase cannot be explained exclusively by improvements in diagnostic methods or by changes in classification. The reason for the increase is unclear, but there has also been an increase in the incidence of Barrett's esophagus, 10 which is strongly associated with esophageal adenocarcinoma. 11 Moreover, there may now be a tendency to consider adenocarcinomas of the lower esophagus and esophagogastric junction as esophageal in origin, rather than postulating a gastric origin for all such lesions.…”

Section: Discussionmentioning

confidence: 99%

Primary adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa

Noguchi

Takeno

Takahashi

et al. 2001

Journal of Gastroenterology

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Most esophageal malignancies are either squamous cell carcinomas or adenocarcinomas arising from Barrett's esophagus. We report a case of adenocarcinoma of the upper esophagus (cervical esophagus) that was derived from heterotopic gastric mucosa. In a 73-year-old man cervical esophagectomy was performed, followed by pharyngectomy, laryngectomy, and palliative dissection of lymph nodes on both sides of the neck, after an accurate diagnosis has been made by esophagography and endoscopy. The resected tumor was smoothly elevated (2.5 cm x 2.0 cm) and was microscopically identified as a well differentiated adenocarcinoma with invasion to the submucosa. The origin of the carcinoma was found to be a heterotopic gastric mucosa, by hematoxylin-eosin (H&E), immunohistochemical, and enzyme histochemical staining. To our knowledge, only 18 similar cases have been reported previously.

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Section: Discussionmentioning

confidence: 99%

Primary adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa

Noguchi

Takeno

Takahashi

et al. 2001

Journal of Gastroenterology

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“…The mean number of resected lymph nodes was 8.6 (range 1-40). The ratio of infiltrated to removed lymph nodes in these 19 pN+ cases was 0.21, and the mean number of resected nodes was 10.0 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. In 16 patients only regional lymph node metastases were present (paraesophageal, paracardial and/or along the lesser curvature), in three patients lymph nodes at the origin of the left gastric artery contained metastatic tumor (M1a).…”

Section: Pathological Findings In the Esophagectomy Specimensmentioning

confidence: 99%

“…Due to increased awareness of the clinical importance of Barrett's esophagus, and the advent of better detection techniques [3,30]), high grade dysplasia (HGD) and early esophageal adenocarcinoma are being diagnosed with increasing frequency in the Western world [5,8,32]. Early carcinoma is defined as a tumor limited to the mucosa or submucosa, irrespective of the presence of lymph node metastases [26].…”

Section: Introductionmentioning

confidence: 99%

Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction

et al. 2005

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Adenocarcinoma of the esophagus, or GEJ, has a poor prognosis. Early lesions [i.e. high grade dysplasia (HGD) or T1-carcinoma] are potentially curable. Local endoscopic therapies are promising treatment options for superficial lesions; however, for deeper lesions, surgical resection is considered to be the treatment of choice. To contribute to therapeutic decision-making, we retrospectively analysed the outcome of transhiatal esophagectomy in 120 patients with pathologically proven HGD (n=13) or T1-adenocarcinoma (n=107) of the distal esophagus or gastro-esophageal junction (GEJ). Tumors were subdivided into six different depths of invasion ('T1-mucosal' m1-m3, 'T1-submucosal' sm1-sm3), and the frequency of lymphatic dissemination and time to locoregional and/or distant recurrence were analysed. Only one of the 79 T1m1-3/sm1 tumors (1%) showed lymph node metastases as compared with 18 out of 41 T1sm2-3 tumors (44%). There was a significant difference in recurrence-free period between T1m1-m3/sm1 versus T1sm2-sm3 tumor patients (P log rank <0.0001), with 5-year recurrence-free percentages of 97% and 57%, respectively. In multivariate analysis including age, gender, tumor differentiation grade, N-stage and depth of invasion, only N-stage was an independent prognostic factor for recurrence-free period (hazard rate=5.9, 95% CI 1.7-20.7). However, if N-stage was excluded from analysis, only depth of invasion (T1sm2-3 versus T1m1-m3/sm1) was an independent prognostic factor for recurrence-free period (hazard rate=7.5, 95% CI 2.0-27.7). These data indicate that T1m1-m3/sm1 adenocarcinomas of esophagus or GEJ show a very low risk of lymphatic dissemination and are therefore eligible for local endoscopic therapy. After transhiatal surgical resection, almost half of the patients with T1sm2-sm3 lesions develop recurrent disease within 5 years, and therefore need additional therapy to improve survival.

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“…Patient ein Adenokarzinom entwickeln [4,5]. Die Inzidenz des Adenokarzinoms hat sich innerhalb von 20 Jahren vervier-bis verfünffacht [6,7]. Der Begriff der endoskopisch negativen oder nichterosiven Refluxerkrankung (NERD) sollte bei Personen angewandt werden, die zwar der Definition der GERD genügen, die aber weder umschriebene endoskopisch erkennbare Schleimhautdefekte noch einen Barrett-Ösophagus aufweisen.…”

Section: Epidemiologieunclassified

Sodbrennen?Symptom oder Krankheit?

Füeßl

2004

coloproctology

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Eine 42-jährige leicht übergewichtige Verkaufsleiterin eines Supermarktes sucht ihren Internisten auf, weil sie seit mehreren Monaten ein brennendes Gefühl hinter dem Brustbein bemerkt. Sie ist früher nie krank gewesen und hat keine Operationen im Bereich des Abdomens durchgemacht. Die Beschwerden haben anfangs nur zwei-bis dreimal pro Woche bestanden, treten in den letzten 2 Monaten aber nahezu täglich auf. Nachdem sie bemerkt hat, dass der Genuss von Zwiebeln und trockenem Rotwein die Intensität und Dauer der Beschwerden fördert, verzichtet sie seit Wochen weitgehend auf beides. Auch den früher üblichen wöchentlichen Besuch des Fitnessstudios hat sie eingestellt, da sich nach körperlichen Anstrengungen das Brennen bis in den Hals erstreckte. In letzter Zeit wacht sie gelegentlich nachts auf, was sie auf das Sodbrennen zurückführt. Auf einen Rat von Bekannten hin hat sie bislang versucht, die Beschwerden durch den Genuss von warmer Milch und Antazida aus der Apotheke zu lindern. Den Besuch beim Arzt hat sie lange hinausgezögert, da in ihrem Bekanntenkreis das Thema Sodbrennen häufig diskutiert worden ist und sie festgestellt hat, dass mehrere Personen zum Teil seit Jahren damit leben. Nachdem es in der letzten Woche auch zweimal zu heftigem sauren Aufstoßen und Erbrechen gekommen ist, ist sie jedoch beunruhigt und fühlt sich durch die Beschwerden doch erheblich beeinträchtigt. Im Anamnesegespräch stellt sich heraus, dass die Patientin wegen des gestörten Schlafs häufig tagsüber müde ist, körperliche Anstrengungen und sportliche Betätigungen sowie Einladungen und Restaurantbesuche weitgehend eingestellt hat. In jeder Jackentasche und in jeder Handtasche hat sie mehrere Beutel mit Antazida, von denen sie zuletzt 10 bis 15 pro Tag eingenommen hat.Fortsetzung S. 364

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Adenocarcinoma of the esophagus and Barrett's esophagus: a population-based study

Cited by 76 publications

References 0 publications

Primary adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa

Primary adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa

Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction

Sodbrennen?Symptom oder Krankheit?

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