Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer)
Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Siewert, J. Rüdiger [verfasserIn] |
|---|
| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2003 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2003 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 27(2003), 9 vom: 21. Aug., Seite 1058-1061 |
|---|---|
| Übergeordnetes Werk: |
volume:27 ; year:2003 ; number:9 ; day:21 ; month:08 ; pages:1058-1061 |
| Links: |
|---|
| DOI / URN: |
10.1007/s00268-003-7061-1 |
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SPR003399583 |
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| 520 | |a Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. | ||
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10.1007/s00268-003-7061-1 doi (DE-627)SPR003399583 (SPR)s00268-003-7061-1-e DE-627 ger DE-627 rakwb eng Siewert, J. Rüdiger verfasserin aut Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) 2003 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2003 Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. Distal Esophagus (dpeaa)DE-He213 Lymphatic Spread (dpeaa)DE-He213 Squamous Cell Esophageal Cancer (dpeaa)DE-He213 Cervical Anastomosis (dpeaa)DE-He213 Transthoracic Approach (dpeaa)DE-He213 Stein, Hubert J. aut Feith, Marcus aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 27(2003), 9 vom: 21. Aug., Seite 1058-1061 (DE-627)SPR003391159 nnns volume:27 year:2003 number:9 day:21 month:08 pages:1058-1061 https://dx.doi.org/10.1007/s00268-003-7061-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 27 2003 9 21 08 1058-1061 |
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10.1007/s00268-003-7061-1 doi (DE-627)SPR003399583 (SPR)s00268-003-7061-1-e DE-627 ger DE-627 rakwb eng Siewert, J. Rüdiger verfasserin aut Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) 2003 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2003 Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. Distal Esophagus (dpeaa)DE-He213 Lymphatic Spread (dpeaa)DE-He213 Squamous Cell Esophageal Cancer (dpeaa)DE-He213 Cervical Anastomosis (dpeaa)DE-He213 Transthoracic Approach (dpeaa)DE-He213 Stein, Hubert J. aut Feith, Marcus aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 27(2003), 9 vom: 21. Aug., Seite 1058-1061 (DE-627)SPR003391159 nnns volume:27 year:2003 number:9 day:21 month:08 pages:1058-1061 https://dx.doi.org/10.1007/s00268-003-7061-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 27 2003 9 21 08 1058-1061 |
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10.1007/s00268-003-7061-1 doi (DE-627)SPR003399583 (SPR)s00268-003-7061-1-e DE-627 ger DE-627 rakwb eng Siewert, J. Rüdiger verfasserin aut Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) 2003 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2003 Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. Distal Esophagus (dpeaa)DE-He213 Lymphatic Spread (dpeaa)DE-He213 Squamous Cell Esophageal Cancer (dpeaa)DE-He213 Cervical Anastomosis (dpeaa)DE-He213 Transthoracic Approach (dpeaa)DE-He213 Stein, Hubert J. aut Feith, Marcus aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 27(2003), 9 vom: 21. Aug., Seite 1058-1061 (DE-627)SPR003391159 nnns volume:27 year:2003 number:9 day:21 month:08 pages:1058-1061 https://dx.doi.org/10.1007/s00268-003-7061-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 27 2003 9 21 08 1058-1061 |
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10.1007/s00268-003-7061-1 doi (DE-627)SPR003399583 (SPR)s00268-003-7061-1-e DE-627 ger DE-627 rakwb eng Siewert, J. Rüdiger verfasserin aut Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) 2003 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2003 Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. Distal Esophagus (dpeaa)DE-He213 Lymphatic Spread (dpeaa)DE-He213 Squamous Cell Esophageal Cancer (dpeaa)DE-He213 Cervical Anastomosis (dpeaa)DE-He213 Transthoracic Approach (dpeaa)DE-He213 Stein, Hubert J. aut Feith, Marcus aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 27(2003), 9 vom: 21. Aug., Seite 1058-1061 (DE-627)SPR003391159 nnns volume:27 year:2003 number:9 day:21 month:08 pages:1058-1061 https://dx.doi.org/10.1007/s00268-003-7061-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 27 2003 9 21 08 1058-1061 |
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10.1007/s00268-003-7061-1 doi (DE-627)SPR003399583 (SPR)s00268-003-7061-1-e DE-627 ger DE-627 rakwb eng Siewert, J. Rüdiger verfasserin aut Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) 2003 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2003 Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. Distal Esophagus (dpeaa)DE-He213 Lymphatic Spread (dpeaa)DE-He213 Squamous Cell Esophageal Cancer (dpeaa)DE-He213 Cervical Anastomosis (dpeaa)DE-He213 Transthoracic Approach (dpeaa)DE-He213 Stein, Hubert J. aut Feith, Marcus aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 27(2003), 9 vom: 21. Aug., Seite 1058-1061 (DE-627)SPR003391159 nnns volume:27 year:2003 number:9 day:21 month:08 pages:1058-1061 https://dx.doi.org/10.1007/s00268-003-7061-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 27 2003 9 21 08 1058-1061 |
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Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) |
| abstract |
Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. © Société Internationale de Chirurgie 2003 |
| abstractGer |
Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. © Société Internationale de Chirurgie 2003 |
| abstract_unstemmed |
Abstract Barrett’s carcinoma, usually arising in the distal esophagus, must be considered a separate entity from squamous cell esophageal cancer. Epidemiology, etiology, patients’ risk profiles, biology of metastases, and prognosis differ markedly between these two major esophageal tumor types. The preoperative work-up of patients with Barrett’s cancer is primarily directed toward assessing the chances for R0 resection and estimating the risk of the patient to survive an esophagectomy. If R0 resection appears likely and the surgical risk is acceptable, the indication for an operative approach is given. From the oncologic point of view there is no difference between a radical transmediastinal approach and a transthoracic approach. A possible advantage of a transthoracic approach is the extension of lymphadenectomy to the upper mediastinum. Lymph node metastases in the upper mediastinum, however, usually indicate advanced lymphatic and subclinical systemic tumor dissemination, i.e., a poor prognosis even with extended surgery. Consequently the controversies about the surgical approach are reduced to technical and functional aspects. A better swallowing function argues for an intrathoracic anastomosis; the lower morbidity, for a cervical approach. We prefer transthoracic en bloc esophagectomy with an intrathoracic anastomosis in patients with moderate risk and early tumor stages. In all other patients radical transmediastinal esophagectomy with a cervical anastomosis is the procedure of choice. The overall 5-year survival rate of more than 40%, which is superior to most published data, supports this therapeutic strategy. © Société Internationale de Chirurgie 2003 |
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| title_short |
Surgical Approach to Invasive Adenocarcinoma of the Distal Esophagus (Barrett’s Cancer) |
| url |
https://dx.doi.org/10.1007/s00268-003-7061-1 |
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| author2 |
Stein, Hubert J. Feith, Marcus |
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Stein, Hubert J. Feith, Marcus |
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| doi_str |
10.1007/s00268-003-7061-1 |
| up_date |
2024-07-03T19:19:02.375Z |
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7.398967 |