Gastroenterology
Volume 137, Issue 3 , Pages 815-823 , September 2009

Endoscopic and Surgical Treatment of Mucosal (T1a) Esophageal Adenocarcinoma in Barrett's Esophagus

  • Ganapathy A. Prasad

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Tsung Teh Wu

      Affiliations

    • Department of Laboratory Medicine and Anatomic Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Dennis A. Wigle

      Affiliations

    • Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Navtej S. Buttar

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Louis–Michel Wongkeesong

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Kelly T. Dunagan

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Lori S. Lutzke

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Lynn S. Borkenhagen

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
  • ,
  • Kenneth K. Wang

      Affiliations

    • Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
    • Corresponding Author InformationReprint requests Kenneth K. Wang, MD, Alfred Main, St. Mary's Hospital, 200, First Street SW, Rochester, Minnesota. fax: (507) 255-7612

Received 6 February 2009 ,Accepted 29 May 2009.

References 

  1. Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97:142–146
  2. Surveillance Epidemiology and End Results. http://seer.cancer.govAccessed April 2009
  3. Kelsen DP, Winter KA, Gunderson LL, et al. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25:3719–3725
  4. Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–1137
  5. Chang AC, Ji H, Birkmeyer NJ, et al. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg. 2008;85:424–429
  6. Stein HJ, Feith M, Bruecher BL, et al. Early esophageal cancer: pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg. 2005;242:566–575
  7. Larghi A, Lightdale CJ, Ross AS, et al. Long-term follow-up of complete Barrett's eradication endoscopic mucosal resection (CBE-EMR) for the treatment of high grade dysplasia and intramucosal carcinoma. Endoscopy. 2007;39:1086–1091
  8. Overholt BF, Panjehpour M, Halberg DL. Photodynamic therapy for Barrett's esophagus with dysplasia and/or early stage carcinoma: long-term results. Gastrointest Endosc. 2003;58:183–188
  9. Pech O, May A, Gossner L, et al. Curative endoscopic therapy in patients with early esophageal squamous-cell carcinoma or high-grade intraepithelial neoplasia. Endoscopy. 2007;39:30–35
  10. Schembre DB, Huang JL, Lin OS, et al. Treatment of Barrett's esophagus with early neoplasia: a comparison of endoscopic therapy and esophagectomy. Gastrointest Endosc. 2008;67:595–601
  11. Pacifico RJ, Wang KK, Wongkeesong LM, et al. Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus. Clin Gastroenterol Hepatol. 2003;1:252–257
  12. Pech O, Behrens A, May A, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett's oesophagus. Gut. 2008;57:1200–1206
  13. Prasad GA, Buttar NS, Wongkeesong LM, et al. Significance of neoplastic involvement of margins obtained by endoscopic mucosal resection in Barrett's esophagus. Am J Gastroenterol. 2007;102:2380–2386
  14. Peters FP, Kara MA, Curvers WL, et al. Multiband mucosectomy for endoscopic resection of Barrett's esophagus: feasibility study with matched historical controls. Eur J Gastroenterol Hepatol. 2007;19:311–315
  15. Prasad GA, Wang KK, Buttar NS, et al. Long-term survival following endoscopic and surgical treatment of high-grade dysplasia in Barrett's esophagus. Gastroenterology. 2007;132:1226–1233
  16. Montgomery E, Bronner MP, Goldblum JR, et al. Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol. 2001;32:368–378
  17. Montgomery E, Goldblum JR, Greenson JK, et al. Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: a follow-up study based on 138 cases from a diagnostic variability study. Hum Pathol. 2001;32:379–388
  18. Lewis JT, Wang KK, Abraham SC. Muscularis mucosae duplication and the musculo-fibrous anomaly in endoscopic mucosal resections for Barrett esophagus: implications for staging of adenocarcinoma. Am J Surg Pathol. 2008;32:566–571
  19. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383
  20. D'Agostino RB. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17:2265–2281
  21. Das A, Singh V, Fleischer DE, et al. A comparison of endoscopic treatment and surgery in early esophageal cancer: an analysis of surveillance epidemiology and end results data. Am J Gastroenterol. 2008;103:1340–1345
  22. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349:2241–2252
  23. Chang LC, Oelschlager BK, Quiroga E, et al. Long-term outcome of esophagectomy for high-grade dysplasia or cancer found during surveillance for Barrett's esophagus. J Gastrointest Surg. 2006;10:341–346
  24. Bizekis C, Kent MS, Luketich JD, et al. Initial experience with minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg. 2006;82:402–407
  25. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg. 2003;238:486–495
  26. Luketich JD, Landreneau RJ. Minimally invasive resection and mechanical cervical esophagogastric anastomotic techniques in the management of esophageal cancer. J Gastrointest Surg. 2004;8:927–929
  27. Luketich JD, Schauer PR, Christie NA, et al. Minimally invasive esophagectomy. Ann Thorac Surg. 2000;70:906–912
  28. Peyre CG, DeMeester SR, Rizzetto C, et al. Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasia. Ann Surg. 2007;246:665–674
  29. Pech O, Gossner L, May A, et al. Long-term results of photodynamic therapy with 5-aminolevulinic acid for superficial Barrett's cancer and high-grade intraepithelial neoplasia. Gastrointest Endosc. 2005;62:24–30
  30. Chang CC, Fang CL, Lou HY, et al. Metachronous esophageal cancer and colon cancer treated by endoscopic mucosal resection. J Formos Med Assoc. 2007;106:S5–S9
  31. May A, Gossner L, Pech O, et al. Intraepithelial high-grade neoplasia and early adenocarcinoma in short-segment Barrett's esophagus (SSBE): curative treatment using local endoscopic treatment techniques. Endoscopy. 2002;34:604–610
  32. Ell C, May A, Pech O, et al. Curative endoscopic resection of early esophageal adenocarcinomas (Barrett's cancer). Gastrointest Endosc. 2007;65:3–10
  33. Esaki M, Matsumoto T, Hirakawa K, et al. Risk factors for local recurrence of superficial esophageal cancer after treatment by endoscopic mucosal resection. Endoscopy. 2007;39:41–45
  34. Pouw RE, Gondrie JJ, Sondermeijer CM, et al. Eradication of Barrett esophagus with early neoplasia by radiofrequency ablation, with or without endoscopic resection. J Gastrointest Surg. 2008;12:1627–1637
  35. Seewald S, Ang TL, Groth S, et al. Detection and endoscopic therapy of early esophageal adenocarcinoma. Curr Opin Gastroenterol. 2008;24:521–529

 Conflicts of interest The authors disclose no conflicts.

 Funding Supported by National Institutes of Health grants R01CA111603-01A1 (K.K.W.), R01CA097048 (K.K.W.), R21CA122426-01 (K.K.W.), and R03CA135991-01 (G.A.P.), and the Shirley and Miles Fiterman Digestive Disease Center.

PII: S0016-5085(09)00914-7

doi: 10.1053/j.gastro.2009.05.059

Gastroenterology
Volume 137, Issue 3 , Pages 815-823 , September 2009