Universität zu Köln

Labenz, Joachim, Koop, Herbert, Tannapfel, Andrea, Kiesslich, Ralf and Hoelscher, Arnulf H. (2015). The Epidemiology, Diagnosis, and Treatment of Barrett's Carcinoma. Dtsch. Arztebl. Int., 112 (13). S. 224 - 236. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Roughly 3000 new cases of Barrett's carcinoma arise in Germany each year. In view of recent advances in the epidemiology, diagnosis, and treatment of this disease, an update of the clinical recommendations is in order. Methods: This review is based on selected relevant publications, including current reviews, meta-analyses, and guidelines. Results: The risk of progression of Barrett's esophagus to carcinoma lies between 0.10% and 0.15% per year. Risk factors for progression include male sex, age over 50 years, obesity, longstanding and frequent reflux symptoms, smoking, length of the Barrett's esophagus, and intraepithelial neoplasia. Well-differentiated carcinomas that are confined to the esophageal mucosa can be resected endoscopically with a cure rate above 90%. For more advanced, but still locally confined tumors, surgical resection is the treatment of choice. In stages cT3/4, the prognosis can be improved with neo-adjuvant chemo therapy or combined radiotherapy and chemotherapy. Metastatic Barrett's carcinoma can be treated by endoscopic, chemotherapeutic, radiotherapeutic, and palliative methods. Conclusion: Early carcinoma can often be cured by endoscopic resection. Locally advanced carcinoma calls for multimodal treatment. Current research focuses on means of preventing the progression of Barrett's esophagus, the scope of applicability of endoscopic techniques, and the optimization of multimodal treatment strategies for advanced disease.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Labenz, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Koop, Herbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Tannapfel, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiesslich, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-404643
DOI:	10.3238/arztebl.2015.0224
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	112
Number:	13
Page Range:	S. 224 - 236
Date:	2015
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GASTROESOPHAGEAL-REFLUX DISEASE; LOW-GRADE DYSPLASIA; LIFE-STYLE FACTORS; RADIOFREQUENCY ABLATION; ESOPHAGEAL ADENOCARCINOMA; INTESTINAL METAPLASIA; ENDOSCOPIC RESECTION; NEOADJUVANT CHEMOTHERAPY; RESECTABLE ESOPHAGEAL; HELICOBACTER-PYLORI Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40464