[Barrett carcinoma as a tumor entity with special therapy consequences]

The development of columnar lined epithelium with intestinal metaplasia in the distal esophagus is a possible, but not a necessary, end stage of advanced gastroesophageal reflux disease. Currently, research is focused on the carcinogenesis of Barrett's carcinoma and the metaplasia-dysplasia carcinoma sequence, since it is a malignoma with the highest increasing incidence in Western industrial countries. Possible causes of the above-mentioned sequence are excessive acid, duodenogastric reflux, and genetic factors. A curative surgical approach is the radical R-0 resection. Some centers prefer the transmediastinal esophagectomy. Others prefer the transthoracic en bloc esophagectomy. Reconstruction can be done with the stomach and the colon. Patients with advanced disease probably benefit best from multimodal therapy with neoadjuvant radiochemotherapy.