TITLE

Preoperative chemotherapy unmasks underlying Barrett’s Mucosa in patients with adenocarcinoma of the distal esophagus: Theisen J, Stein HJ, Dittler HJ, et al., Lifting the Veil on Esophageal Adenocarcinoma, Surg Endosc 2002;16:671–3

AUTHOR(S)
Aguirre, Thomas V.; Sampliner, Richard E.
PUB. DATE
April 2003
SOURCE
American Journal of Gastroenterology;Apr2003, Vol. 98 Issue 4, p933
SOURCE TYPE
Academic Journal
DOC. TYPE
Editorial
ABSTRACT
The histology of participants of a phase II prospective study of neoadjuvant chemotherapy for esophageal cancer was reviewed. The presence (or absence) of Barrett’s esophagus (BE) was identified by pre- and post-chemotherapy endoscopy. The investigators hoped to assess the hypothesis that most esophageal adenocarcinomas are associated with BE and that tumor overgrowth may obscure its presence.Seventy-nine consecutive patients with locally advanced esophageal adenocarcinoma had pre- and post-chemotherapy endoscopy with biopsies. All patients went on to have a resection. Patients with cancers of the gastroesophageal junction were excluded. BE was identified at endoscopy when the squamocolumnar junction was found to be proximal to the gastroesophageal junction. The tumor and adjacent areas were “extensively” biopsied. The presence of BE was confirmed by histopathological presence of specialized columnar epithelium with intestinal metaplasia and goblet cells.Among the patients, 94% were men, 99% had T3-stage tumor, 77% had reflux symptoms, 78% had hiatal hernias, and 75% had BE on pre-chemotherapy endoscopy. The absolute increase in diagnostic yield of BE at post-chemotherapy endoscopy was 22.4%. The patients without BE at either endoscopy were intolerant of chemotherapy suggesting no shrinkage of tumor. Overall, BE was found in 97.4% of patients with esophageal adenocarcinoma.
ACCESSION #
9658117

 

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