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Carcinoma arising in Barrett's esophagus
H Li1, T N Walsh, T P Hennessy
1University Department of Surgery, Trinity College Medical School, St. James's Hospital, Dublin, Ireland.
Surgery, Gynecology & Obstetrics
|August 1, 1992
Summary
Barrett's esophagus-associated adenocarcinoma in the esophagus is a significant challenge. Early-stage diagnosis and surgical intervention improve survival rates for this cancer.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Esophageal Cancer Research
Background:
- Barrett's esophagus is a known precursor to esophageal adenocarcinoma.
- Surgical resection is a primary treatment for esophageal carcinoma.
Purpose of the Study:
- To analyze the outcomes of surgical resection for esophageal carcinoma in patients with Barrett's esophagus.
- To identify prognostic factors for survival in this patient cohort.
Main Methods:
- Retrospective review of 500 esophageal carcinoma resections between 1971-1990.
- Analysis of 51 patients with concurrent Barrett's esophagus.
- Evaluation of tumor stage, length, and survival rates.
Main Results:
- Adenocarcinoma was the predominant histology (49/51) in Barrett's-associated esophageal cancer.
- Tumor stage and length were significant prognostic factors.
- Five-year survival was 25% for Stage II vs. 4.5% for Stages III/IV; 21% for <6cm tumors vs. 0% for >6cm tumors.
- Hospital mortality decreased significantly after 1986.
Conclusions:
- Surgical outcomes for esophageal adenocarcinoma in Barrett's esophagus have improved over time.
- Tumor stage and length are critical determinants of survival.
- Adjuvant therapies and improved surgical techniques may have contributed to reduced mortality.