World Journal of Surgery

, Volume 27, Issue 9, pp 1062–1066

Results of Surgical Therapy in Patients with Barrett’s Adenocarcinoma

  • Luigi Bonavina
  • Albert Via
  • Raffaello Incarbone
  • Greta Saino
  • Alberto Peracchia
World Progress in Surgery

DOI: 10.1007/s00268-003-7062-0

Cite this article as:
Bonavina, L., Via, A., Incarbone, R. et al. World J. Surg. (2003) 27: 1062. doi:10.1007/s00268-003-7062-0

Abstract

The incidence of adenocarcinoma arising from Barrett’s esophagus is dramatically increasing in Western countries. The purpose of this study was to report our experience in the surgical management of these patients. Between November 1992 and December 2000, 330 consecutive patients with adenocarcinoma of the esophagogastric junction were observed in our institution. Of these, 105 (31.8%) had Barrett’s carcinoma. In 12 individuals (11.4%) adenocarcinoma was discovered during endoscopic surveillance for Barrett’s esophagus. Twelve patients with doubtful cleavage planes at preoperative investigation were treated with neoadjuvant chemotherapy. Overall, 80 patients (76.2%) underwent esophagectomy without operative mortality. The Ivor Lewis approach was used in 70 patients; of these, 31 underwent extended mediastinal lymph node dissection. Seventy-four patients (92.5%) had R0 resection. The overall 5-year survival rate was 48%. Survival was significantly associated with stage, lymph node status, and completeness of resection. Early diagnosis remains the prerequisite for curative treatment of esophageal carcinoma. An extended mediastinal lymphadenectomy does not increase morbidity, allows precise tumor staging, and may prove effective in preventing local recurrences. Neoadjuvant therapy requires major improvement before it can be unconditionally recommended outside clinical trials.

Copyright information

© Société Internationale de Chirurgie 2003

Authors and Affiliations

  • Luigi Bonavina
    • 1
  • Albert Via
    • 1
  • Raffaello Incarbone
    • 1
  • Greta Saino
    • 1
  • Alberto Peracchia
    • 1
  1. 1.Department of SurgeryUniversity of Milano, Istituto Policlinico San DonatoSan Donato Milanese (Milano)Italy