Document Detail


Results of surgical therapy in patients with Barrett's adenocarcinoma.
MedLine Citation:
PMID:  12917757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Luigi Bonavina; Albert Via; Raffaello Incarbone; Greta Saino; Alberto Peracchia
Related Documents :
22228157 - Long-term quality of life and sexual and urinary function after abdominoperineal resect...
23393367 - Lenograstim in preventing chemotherapy-induced febrile neutropenia in patients with sof...
10638607 - Optimal treatment for localized esophageal cancer still uncertain.
16733107 - Staging of esophageal carcinoma in a low-volume eus center compared with reported resul...
8263847 - Evaluation of prognostic factors and sequential combination chemotherapy with doxorubic...
11263287 - The analgesic action of semen coicis on severe functional dysmenorrhea--a sequential tr...
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2003-08-18
Journal Detail:
Title:  World journal of surgery     Volume:  27     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-10-15     Completed Date:  2004-03-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1062-6     Citation Subset:  IM    
Affiliation:
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:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / 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


Previous Document:  Impact of advanced age on the outcome of liver resection.
Next Document:  Pattern of lymphatic spread of Barrett's cancer.