Therapeutic Options in Patients with Barrett’s Esophagus

Lim, Kie N.; Waring, Patrick J.; Saidi, Roxan

doi:10.1159/000016919

Cited by 9 publications

(6 citation statements)

References 49 publications

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“…In the US and other Western countries, overall rates of esophageal cancer (EC) as well as squamous cell carcinoma (SCC) have been decreasing 1,2 probably due to the reductions in the rate of cigarette smoking, 3,4 while rates of adenocarcinoma (AC) have been on the rise, 5 probably as a consequence of increasing Barrett's esophagus. [6][7][8] In fact, AC has supplanted SCC as the predominant histological type of EC in the US and currently accounts for over half of new esophageal cancers in the US, especially among white males. 9 The southern side of the Caspian littoral historically has had high rates of esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

A histopathological study of esophageal cancer on the western side of the Caspian littoral from 1994 to 2003

2008

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Esophageal cancer (EC) accounts for a considerable proportion of carcinomas of the upper gastrointestinal tract in the population of the Caspian littoral. The global histologic pattern of the disease has changed recently. The intent of this study was to determine the incidence of EC over the past decade in Eastern Azerbaijan--a north-western province of Iran--on the western side of the Caspian littoral and to assess the alteration of the histological pattern of the disease. In a retrospective study, all 1792 documented EC cases of all registered cancer, surgery, pathology, and radiotherapy centers of the province over a period of 9 years (from March 1994 to March 2003) were enrolled in the study. Data concerning demographic characteristics, EC risk factors, and histological findings were recorded. The incidence and the relative incidence of the pathological subtypes of EC in the population of the province were determined. The change in incidence rates and the interaction between main risk factors and tumor histology of the patients were assessed over the study years. The average incidence of EC in the over 30-year-old population of the province was 16.2 (12.7 for squamous cell carcinoma [SCC] and 1.9 for adenocarcinoma [AC]) cases per 100 000 person-years. Incidence of SCC, as well as AC, peaked at ages older than 65. Compared to women, men had higher incidences of AC and lower incidences of SCC; the average incidence rate of EC was equal in men and women. AC and SCC accounted for 12.8% and 86.9% of cases, respectively. Upper, middle and lower thirds of the esophagus were the location of tumors in 9.8%, 32.9% and 57.3% of cases, respectively. During the study period, incidence rates of EC and SCC tended to decrease. The incidence rate of EC from 1995 to 1998 was almost 30% higher than that of the period from 1999 to 2002. Incidence rate of EC on the western side of the Caspian littoral is moderately high, but much lower than that of the eastern Caspian littoral as it was three decades ago. The incidence of EC was lower in the second half than the first half of the study period. Unlike the global pattern of EC, the incidence of EC as well as SCC in women is as high as or higher than in men, which is identical to the pattern in the eastern Caspian littoral.

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Section: Introductionmentioning

confidence: 99%

A histopathological study of esophageal cancer on the western side of the Caspian littoral from 1994 to 2003

2008

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“…Thermal destruction is due to the rapid transfer of energy to the target tissue and is strongly related to wavelength. Argon and KTP lasers penetrate tissue to approximately 1 mm, whereas Nd: YAG will cause destruction to 3–4 mm 9,33 The KTP laser offers the advantages of more precise control of depth of injury by variation of pulse duration, however, the relatively shallow depth of injury may result in incomplete destruction of the BE. It is a non‐contact technique with the laser beam applied to the surface in a paintbrush fashion.…”

Section: Methodsmentioning

confidence: 99%

“…7,8 A variety of techniques have been used for the elimination of intestinal metaplasia including laser, photodynamic or electrocoagulation therapy, argon beam plasma coagulation and endoscopic resection. 9 Whichever modality of ablation is used, there are limitations both in terms of efficacy and unwanted effects. The indications for active management of BE and esophageal adenocarcinoma, and the role of ablative techniques in this process are obscure.…”

Section: Introductionmentioning

confidence: 99%

Ablation of Barrett’s epithelium: the promise and the problems

Urosevic

Kiroff

2002

Diseases of the Esophagus

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The incidence of adenocarcinoma of the esophagus has increased dramatically over recent years. Because Barrett's epithelium is recognized as a risk factor for adenocarcinoma there is an interest in reversing this metaplasia. A number of endoscopic methods of destruction of esophageal columnar epithelium have been described. The purpose of this article is to review the currently available methods of managing Barrett's epithelium with particular reference to the role of ablative therapy in reducing the risk of adenocarcinoma.

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“…In spite of publication of the ACG guidelines in the American Journal of Gastroenterology and ample citation of the guidelines in other articles, [22][23][24][25] only 55% of all respondents in our sample were aware of the guidelines 18 months after their publication. Although ACG members were more likely to be aware than nonmembers, only 61% of the former group knew of the guidelines despite uniform distribution of the journal to all society members.…”

Section: Commentmentioning

confidence: 99%