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Tan WK, Maroni R, Offman J, Zamani SA, Sasieni PD, Fitzgerald RC. Targeted Screening for Barrett's Esophagus and Esophageal Cancer: Post Hoc Analysis From the Randomized BEST3 Trial. Gastroenterology 2024:S0016-5085(24)00495-5. [PMID: 38718951 DOI: 10.1053/j.gastro.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 06/04/2024]
Affiliation(s)
- W Keith Tan
- Early Cancer Institute, Department of Oncology, University of Cambridge, Cambridge, United Kingdom.
| | - Roberta Maroni
- King's College London Cancer Prevention Trials Unit, Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King's College London, Innovation Hub, Guys Cancer Centre, Guy's Hospital, Great Maze Pond, United Kingdom
| | - Judith Offman
- Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom; School of Cancer & Pharmaceutical Sciences, King's College London, Innovation Hub, Guys Cancer Centre, Guy's Hospital, Great Maze Pond, London, United Kingdom
| | - Shahriar A Zamani
- Early Cancer Institute, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Peter D Sasieni
- King's College London Cancer Prevention Trials Unit, Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, King's College London, Innovation Hub, Guys Cancer Centre, Guy's Hospital, Great Maze Pond, United Kingdom; Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
| | - Rebecca C Fitzgerald
- Early Cancer Institute, Department of Oncology, University of Cambridge, Cambridge, United Kingdom.
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Zheng YH, Zhao EH. Recent advances in multidisciplinary therapy for adenocarcinoma of the esophagus and esophagogastric junction. World J Gastroenterol 2022; 28:4299-4309. [PMID: 36159003 PMCID: PMC9453767 DOI: 10.3748/wjg.v28.i31.4299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/22/2022] [Accepted: 07/22/2022] [Indexed: 02/06/2023] Open
Abstract
Esophageal adenocarcinoma (EAC) and adenocarcinoma of the esophagogastric junction (EGJA) have long been associated with poor prognosis. With changes in the spectrum of the disease caused by economic development and demographic changes, the incidence of EAC and EGJA continues to increase, making them worthy of more attention from clinicians. For a long time, surgery has been the mainstay treatment for EAC and EGJA. With advanced techniques, endoscopic therapy, radiotherapy, chemotherapy, and other treatment methods have been developed, providing additional treatment options for patients with EAC and EGJA. In recent decades, the emergence of multidisciplinary therapy (MDT) has enabled the comprehensive treatment of tumors and made the treatment more flexible and diversified, which is conducive to achieving standardized and individualized treatment of EAC and EGJA to obtain a better prognosis. This review discusses recent advances in EAC and EGJA treatment in the surgical-centered MDT mode in recent years.
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Affiliation(s)
- Yi-Han Zheng
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - En-Hao Zhao
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Puthenpura MM, Sanaka KO, Qin Y, Thota PN. Management of nondysplastic Barrett’s esophagus: When to survey? When to ablate? Ther Adv Chronic Dis 2022; 13:20406223221086760. [PMID: 35432847 PMCID: PMC9008814 DOI: 10.1177/20406223221086760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022] Open
Abstract
Barrett’s esophagus (BE), a precursor for esophageal adenocarcinoma (EAC), is
defined as salmon-colored mucosa extending more than 1 cm proximal to the
gastroesophageal junction with histological evidence of intestinal metaplasia.
The actual risk of EAC in nondysplastic Barrett’s esophagus (NDBE) is low with
an annual incidence of 0.3%. The mainstay in the management of NDBE is control
of gastroesophageal reflux disease (GERD) along with enrollment in surveillance
programs. The current recommendation for surveillance is four-quadrant biopsies
every 2 cm (or 1 cm in known or suspected dysplasia) followed by biopsy of
mucosal irregularity (nodules, ulcers, or other visible lesions) performed at 3-
to 5-year intervals. Challenges to surveillance include missed cancers,
suboptimal adherence to surveillance guidelines, and lack of strong evidence for
efficacy. There is minimal role for endoscopic eradication therapy in NDBE. The
role for enhanced imaging techniques, artificial intelligence, and risk
prediction models using clinical data and molecular markers is evolving.
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Affiliation(s)
- Max M. Puthenpura
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Krishna O. Sanaka
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Yi Qin
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Prashanthi N. Thota
- Center of Excellence for Barrett’s Esophagus, Department of Gastroenterology/A30, Digestive Disease & Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195,USA
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