Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

Rubenstein, Joel H.; Shaheen, Nicholas J.

doi:10.1053/j.gastro.2015.04.053

Cited by 307 publications

(297 citation statements)

References 155 publications

(165 reference statements)

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“…GERD can lead to erosive esophagitis and (after an aberrant healing process) to a metaplastic, specialized intestinal epithelium (ie Barrett's esophagus) 38. Among the 6‐14% of GERD patients who develop Barrett's esophagus, 0.5‐1% will progress to adenocarcinoma 39.…”

Section: Microbiome In Esophagitis and Barrett's Esophagusmentioning

confidence: 99%

Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications

Baba

Iwatsuki

Yoshida

et al. 2017

Annals of Gastroent Surgery

104

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Esophageal cancer ranks among the most aggressive malignant diseases. The limited improvements in treatment outcomes provided by conventional therapies have prompted us to seek innovative strategies for treating this cancer. More than 100 trillion microorganisms inhabit the human intestinal tract and play a crucial role in health and disease conditions, including cancer. The human intestinal microbiome is thought to influence tumor development and progression in the gastrointestinal tract by various mechanisms. For example, Fusobacterium nucleatum, which primarily inhabits the oral cavity and causes periodontal disease, might contribute to aggressive tumor behavior through activation of chemokines such as CCL20 in esophageal cancer tissue. Composition of the intestinal microbiota is influenced by diet, lifestyle, antibiotics, and pro‐ and prebiotics. Therefore, by better understanding how the bacterial microbiota contributes to esophageal carcinogenesis, we might develop novel cancer prevention and treatment strategies through targeting the gastrointestinal microflora. This review discusses the current knowledge, available data and information on the relationship of microbiota with esophagitis, Barrett's esophagus, esophageal adenocarcinoma and squamous cell carcinoma.

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Section: Microbiome In Esophagitis and Barrett's Esophagusmentioning

confidence: 99%

Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications

Baba

Iwatsuki

Yoshida

et al. 2017

Annals of Gastroent Surgery

104

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“…Patients with advanced gastric cancer rarely achieve long-term survival, and the median survival is 8-14 months [2,3]. In addition, the incidence of gastroesophageal junction adenocarcinoma has increased considerably in the past 40 years, especially in industrialized countries [4].…”

Section: Introductionmentioning

confidence: 99%

PTEN loss is associated with a poor response to trastuzumab in HER2-overexpressing gastroesophageal adenocarcinoma

et al. 2016

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Background Although trastuzumab improves the outcome of patients with human epidermal growth factor receptor 2 (HER2)-overexpressing gastric or gastroesophageal junction adenocarcinoma (collectively referred to as ''gastroesophageal adenocarcinoma''; GEA), no clinical response is observed in a substantial population of patients. A predictive biomarker of trastuzumab response is required. The aim of this study was to evaluate whether the hyperactivation of the downstream phosphatidylinositol 3-kinase pathway, due to phosphatase and tensin homolog (PTEN) loss or PIK3CA mutations, could provide trastuzumab resistance in GEA. Methods Expression of HER2 and PTEN, and PIK3CA gene mutations were screened in 264 surgically resected GEA specimens. The effects of PTEN knockdown on the response to trastuzumab on cell viability, HER2 downstream signaling, apoptosis, and cell cycle were evaluated in HER2-overexpressing NCI-N87 gastric adenocarcinoma and OE19 esophageal adenocarcinoma cell lines. Inhibition of xenograft tumor growth by trastuzumab was investigated in OE19 cells with or without PTEN knockdown. The PTEN expression and objective response were analyzed in 23 GEA patients who received trastuzumab-based therapy.Results PTEN loss was identified in 34.5 % of HER2-overexpressing GEA patients, whereas PIK3CA mutations were rare (5.6 %). Trastuzumab-mediated growth suppression, apoptosis, and G 1 cell cycle arrest were inhibited by PTEN knockdown through Akt activation in NCI-N87 and OE19 cells. PTEN knockdown impaired the antiproliferative effect of trastuzumab in OE19 xenograft models. A clinical response was observed in 50 % of PTEN-positive tumors (9 of 18) but in no tumors with PTEN loss (none of 5). Conclusions PTEN loss was frequently found in HER2-overexpressing tumors, and was associated with a poor response to trastuzumab-based therapy in patients with GEA.

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“…Ageing is one of the risk factors for EAC (4). However, the incidence of EAC in each age group, particularly in young people has risen significantly according to epidemiological studies (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological features and prognosis of patients <45 years old with esophageal adenocarcinoma comparing to other age groups

Yang

Jia

et al. 2016

J. Thorac. Dis.

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Background: To analyze the clinicopathological features and prognosis of younger patients with esophageal adenocarcinoma (EAC). Methods: A total of 2,601 patients diagnosed with EAC between 1988 and 2011 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients underwent primary tumor resection and regional lymphadenectomy without preoperative radiotherapy. The patients were into four age groups (<45, 45-59, 60-74, ≥75), with 94, 813, 1,272 and 422 patients in each group respectively. Results: Patients in the age <45 group were more likely to have lymph node (LN) metastasis (P=0.002), postoperative radiotherapy (P<0.001) and advanced T and N stage (P=0.003, 0.014) compared to the other three groups. We then conducted two Cox proportional hazards model adjusted for the sex, race, number of LNs examined, histological grade, postoperative radiation. The hazard ratio (HR) was higher in patients <45 y and the survival rate were paradoxically lower compared to the patients between 45-60 years old (P=0.046, 0.039). Conclusions: The patients <45 y had the most aggressive clinicopathological features of EAC and poorer survival rate after radical esophagectomy.

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Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

Cited by 307 publications

References 155 publications

Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications

Review of the gut microbiome and esophageal cancer: Pathogenesis and potential clinical implications

PTEN loss is associated with a poor response to trastuzumab in HER2-overexpressing gastroesophageal adenocarcinoma

Clinicopathological features and prognosis of patients <45 years old with esophageal adenocarcinoma comparing to other age groups

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