| Results of surgical therapy in patients with Barrett's adenocarcinoma. | |
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MedLine Citation:
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PMID: 12917757 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The incidence of adenocarcinoma arising from Barrett's esophagus is dramatically increasing in Western countries. The purpose of this study was to report our experience in the surgical management of these patients. Between November 1992 and December 2000, 330 consecutive patients with adenocarcinoma of the esophagogastric junction were observed in our institution. Of these, 105 (31.8%) had Barrett's carcinoma. In 12 individuals (11.4%) adenocarcinoma was discovered during endoscopic surveillance for Barrett's esophagus. Twelve patients with doubtful cleavage planes at preoperative investigation were treated with neoadjuvant chemotherapy. Overall, 80 patients (76.2%) underwent esophagectomy without operative mortality. The Ivor Lewis approach was used in 70 patients; of these, 31 underwent extended mediastinal lymph node dissection. Seventy-four patients (92.5%) had R0 resection. The overall 5-year survival rate was 48%. Survival was significantly associated with stage, lymph node status, and completeness of resection. Early diagnosis remains the prerequisite for curative treatment of esophageal carcinoma. An extended mediastinal lymphadenectomy does not increase morbidity, allows precise tumor staging, and may prove effective in preventing local recurrences. Neoadjuvant therapy requires major improvement before it can be unconditionally recommended outside clinical trials. |
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Authors:
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Luigi Bonavina; Albert Via; Raffaello Incarbone; Greta Saino; Alberto Peracchia |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2003-08-18 |
Journal Detail:
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Title: World journal of surgery Volume: 27 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-10-15 Completed Date: 2004-03-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1062-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Milano, Istituto Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milano, Italy. luigi.bonavina@unimi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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etiology,
mortality,
surgery* Adult Aged Aged, 80 and over Barrett Esophagus / complications, mortality, surgery* Esophageal Neoplasms / etiology, mortality, surgery* Esophagectomy* Female Humans Lymph Node Excision* Male Middle Aged Retrospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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