Preoperative chemotherapy unmasks underlying Barrett's mucosa in patients with adenocarcinoma of the distal esophagus
Intestinal metaplasia of the distal esophagus frequently cannot be detected in patients with esophageal adenocarcinoma. It has therefore been questioned whether Barrett's esophagus is the primary precursor lesion of such lesions. We hypothesized that the underlying Barrett's mucosa may be...
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| Veröffentlicht in: | Surgical endoscopy 2002-04, Vol.16 (4), p.671-673 |
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| creator | THEISEN, J STEIN, H. J DITTLER, H. J FEITH, M MOEBIUS, C KAUER, W. K. H WERNER, M SIEWERT, J. R |
| description | Intestinal metaplasia of the distal esophagus frequently cannot be detected in patients with esophageal adenocarcinoma. It has therefore been questioned whether Barrett's esophagus is the primary precursor lesion of such lesions. We hypothesized that the underlying Barrett's mucosa may be masked by tumor overgrowth in the majority of these patients.
The pretherapeutic endoscopy and biopsy records of 79 patients with locally advanced esophageal adenocarcinoma who had undergone preoperative chemotherapy were reviewed and compared to findings on restaging endoscopy/biopsy and subsequent resection and histopathologic analysis of the resected specimen.
Pretherapeutic endoscopy and biopsy showed associated Barrett's esophagus in 59/79 patients, whereas there was no evidence of associated intestinal metaplasia in 20/79 patients on extensive biopsies. Following neoadjuvant chemotherapy, Barrett's mucosa was unmasked and later documented by biopsy or histopathologic assessment of the resected specimen in 18 of the latter 20 patients. This resulted in an overall association of Barrett's mucosa with adenocarcinoma in the distal esophagus of 97.4%
Underlying Barrett's mucosa is frequently masked by tumor overgrowth in patients with locally advanced adenocarcinoma of the distal esophagus. |
| doi_str_mv | 10.1007/s00464-001-8307-3 |
| format | Article |
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The pretherapeutic endoscopy and biopsy records of 79 patients with locally advanced esophageal adenocarcinoma who had undergone preoperative chemotherapy were reviewed and compared to findings on restaging endoscopy/biopsy and subsequent resection and histopathologic analysis of the resected specimen.
Pretherapeutic endoscopy and biopsy showed associated Barrett's esophagus in 59/79 patients, whereas there was no evidence of associated intestinal metaplasia in 20/79 patients on extensive biopsies. Following neoadjuvant chemotherapy, Barrett's mucosa was unmasked and later documented by biopsy or histopathologic assessment of the resected specimen in 18 of the latter 20 patients. This resulted in an overall association of Barrett's mucosa with adenocarcinoma in the distal esophagus of 97.4%
Underlying Barrett's mucosa is frequently masked by tumor overgrowth in patients with locally advanced adenocarcinoma of the distal esophagus.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-001-8307-3</identifier><identifier>PMID: 11972212</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York, NY: Springer</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - surgery ; Adult ; Aged ; Barrett Esophagus - diagnosis ; Biological and medical sciences ; Diagnosis, Differential ; Endoscopy - methods ; Esophageal Neoplasms - drug therapy ; Esophageal Neoplasms - surgery ; Esophagogastric Junction - drug effects ; Esophagogastric Junction - pathology ; Esophagogastric Junction - surgery ; Esophagus ; Esophagus - drug effects ; Esophagus - pathology ; Esophagus - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Male ; Medical sciences ; Metaplasia - diagnosis ; Middle Aged ; Neoadjuvant Therapy - methods ; Neoplasm Staging - methods ; Preoperative Care - methods ; Tomography, X-Ray Computed ; Tumors ; Ultrasonography, Interventional</subject><ispartof>Surgical endoscopy, 2002-04, Vol.16 (4), p.671-673</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright Springer-Verlag 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-393da22736bbc9a4ccc7879ea4c565382f0796709c235c54bab15a3252eb552a3</citedby><cites>FETCH-LOGICAL-c354t-393da22736bbc9a4ccc7879ea4c565382f0796709c235c54bab15a3252eb552a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13638483$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11972212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>THEISEN, J</creatorcontrib><creatorcontrib>STEIN, H. J</creatorcontrib><creatorcontrib>DITTLER, H. J</creatorcontrib><creatorcontrib>FEITH, M</creatorcontrib><creatorcontrib>MOEBIUS, C</creatorcontrib><creatorcontrib>KAUER, W. K. H</creatorcontrib><creatorcontrib>WERNER, M</creatorcontrib><creatorcontrib>SIEWERT, J. R</creatorcontrib><title>Preoperative chemotherapy unmasks underlying Barrett's mucosa in patients with adenocarcinoma of the distal esophagus</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description>Intestinal metaplasia of the distal esophagus frequently cannot be detected in patients with esophageal adenocarcinoma. It has therefore been questioned whether Barrett's esophagus is the primary precursor lesion of such lesions. We hypothesized that the underlying Barrett's mucosa may be masked by tumor overgrowth in the majority of these patients.
The pretherapeutic endoscopy and biopsy records of 79 patients with locally advanced esophageal adenocarcinoma who had undergone preoperative chemotherapy were reviewed and compared to findings on restaging endoscopy/biopsy and subsequent resection and histopathologic analysis of the resected specimen.
Pretherapeutic endoscopy and biopsy showed associated Barrett's esophagus in 59/79 patients, whereas there was no evidence of associated intestinal metaplasia in 20/79 patients on extensive biopsies. Following neoadjuvant chemotherapy, Barrett's mucosa was unmasked and later documented by biopsy or histopathologic assessment of the resected specimen in 18 of the latter 20 patients. This resulted in an overall association of Barrett's mucosa with adenocarcinoma in the distal esophagus of 97.4%
Underlying Barrett's mucosa is frequently masked by tumor overgrowth in patients with locally advanced adenocarcinoma of the distal esophagus.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Barrett Esophagus - diagnosis</subject><subject>Biological and medical sciences</subject><subject>Diagnosis, Differential</subject><subject>Endoscopy - methods</subject><subject>Esophageal Neoplasms - drug therapy</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagogastric Junction - drug effects</subject><subject>Esophagogastric Junction - pathology</subject><subject>Esophagogastric Junction - surgery</subject><subject>Esophagus</subject><subject>Esophagus - drug effects</subject><subject>Esophagus - pathology</subject><subject>Esophagus - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metaplasia - diagnosis</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Neoplasm Staging - methods</subject><subject>Preoperative Care - methods</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><subject>Ultrasonography, Interventional</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1rFTEUhoNY7LX6A9xIENTV1HxOJkstfkGhXeg6nMlkeqfOJGNORrn_3pR7oeDq5MDzvifwEPKKs0vOmPmAjKlWNYzxppPMNPIJ2XElRSME756SHbOSNcJYdU6eI96ziluun5Fzzq2pjNiR7TaHtIYMZfoTqN-HJZV9XdcD3eIC-AvrHEKeD1O8o58g51DKe6TL5hMCnSJdazTEgvTvVPYUhhCTh-ynmBagaaS1jg4TFphpwLTu4W7DF-RshBnDy9O8ID-_fP5x9a25vvn6_erjdeOlVqWRVg4ghJFt33sLyntvOmNDfelWy06MzNjWMOuF1F6rHnquQQotQq-1AHlB3h1715x-bwGLWyb0YZ4hhrShM7wVWilRwTf_gfdpy7H-zQlulepk11aIHyGfE2IOo1vztEA-OM7cgxB3FOKqEPcgxMmaeX0q3volDI-Jk4EKvD0BgB7mMUP0Ez5yspVdPS__AZtWlI0</recordid><startdate>20020401</startdate><enddate>20020401</enddate><creator>THEISEN, J</creator><creator>STEIN, H. 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Pancreas. Abdomen</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metaplasia - diagnosis</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Neoplasm Staging - methods</topic><topic>Preoperative Care - methods</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><topic>Ultrasonography, Interventional</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>THEISEN, J</creatorcontrib><creatorcontrib>STEIN, H. J</creatorcontrib><creatorcontrib>DITTLER, H. J</creatorcontrib><creatorcontrib>FEITH, M</creatorcontrib><creatorcontrib>MOEBIUS, C</creatorcontrib><creatorcontrib>KAUER, W. K. H</creatorcontrib><creatorcontrib>WERNER, M</creatorcontrib><creatorcontrib>SIEWERT, J. 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J</au><au>DITTLER, H. J</au><au>FEITH, M</au><au>MOEBIUS, C</au><au>KAUER, W. K. H</au><au>WERNER, M</au><au>SIEWERT, J. R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative chemotherapy unmasks underlying Barrett's mucosa in patients with adenocarcinoma of the distal esophagus</atitle><jtitle>Surgical endoscopy</jtitle><addtitle>Surg Endosc</addtitle><date>2002-04-01</date><risdate>2002</risdate><volume>16</volume><issue>4</issue><spage>671</spage><epage>673</epage><pages>671-673</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Intestinal metaplasia of the distal esophagus frequently cannot be detected in patients with esophageal adenocarcinoma. It has therefore been questioned whether Barrett's esophagus is the primary precursor lesion of such lesions. We hypothesized that the underlying Barrett's mucosa may be masked by tumor overgrowth in the majority of these patients.
The pretherapeutic endoscopy and biopsy records of 79 patients with locally advanced esophageal adenocarcinoma who had undergone preoperative chemotherapy were reviewed and compared to findings on restaging endoscopy/biopsy and subsequent resection and histopathologic analysis of the resected specimen.
Pretherapeutic endoscopy and biopsy showed associated Barrett's esophagus in 59/79 patients, whereas there was no evidence of associated intestinal metaplasia in 20/79 patients on extensive biopsies. Following neoadjuvant chemotherapy, Barrett's mucosa was unmasked and later documented by biopsy or histopathologic assessment of the resected specimen in 18 of the latter 20 patients. This resulted in an overall association of Barrett's mucosa with adenocarcinoma in the distal esophagus of 97.4%
Underlying Barrett's mucosa is frequently masked by tumor overgrowth in patients with locally advanced adenocarcinoma of the distal esophagus.</abstract><cop>New York, NY</cop><pub>Springer</pub><pmid>11972212</pmid><doi>10.1007/s00464-001-8307-3</doi><tpages>3</tpages></addata></record> |
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| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - surgery Adult Aged Barrett Esophagus - diagnosis Biological and medical sciences Diagnosis, Differential Endoscopy - methods Esophageal Neoplasms - drug therapy Esophageal Neoplasms - surgery Esophagogastric Junction - drug effects Esophagogastric Junction - pathology Esophagogastric Junction - surgery Esophagus Esophagus - drug effects Esophagus - pathology Esophagus - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Humans Male Medical sciences Metaplasia - diagnosis Middle Aged Neoadjuvant Therapy - methods Neoplasm Staging - methods Preoperative Care - methods Tomography, X-Ray Computed Tumors Ultrasonography, Interventional |
| title | Preoperative chemotherapy unmasks underlying Barrett's mucosa in patients with adenocarcinoma of the distal esophagus |
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