Abstract
Objective: To investigate the prevalence of Barrett's esophagus in patients with adenocarcinomas located at the gastroesophageal junction. Design: A case series of patients who underwent esophagogastrectomy for adenocarcinoma was retrospectively reviewed. Tumors were grouped by location as esophageal, cardiac, and subcardiac, and the prevalence of specialized intestinal metaplasia in the histological specimens was determined. Setting: A university department of surgery that specializes in esophageal diseases. Patients: One hundred patients with adenocarcinoma of the esophagus, cardia, or proximal stomach. Main Outcome: Cardiac adenocarcinomas were associated with Barrett's esophagus in 42% of the patients. Results: Specialized intestinal metaplasia was identified in the histological sections from the resected specimen in 42% (13/31) of cardiac adenocarcinomas and in 79% (38/48) of esophageal adenocarcinomas but in only 5% (1/21) of subcardiac adenocarcinomas. The preoperative endoscopic biopsy results concurred with the final diagnosis of Barrett's esophagus in 33 of the 38 esophageal tumors, six of the 13 cardiac tumors, and the one subcardiac tumor but failed to detect specialized intestinal metaplasia in 54% (7/13) of cardiac tumors. Cardiac tumors were associated with shorter lengths of Barrett's mucosa than esophageal tumors (2.7 ± 1.8 cm vs 7.4 ± 3.4 cm, P<.01). The Barrett's metaplasia was dysplastic in 36 of the 38 esophageal tumors, 10 of the 13 cardiac tumors, but not in the subcardiac tumor. Conclusions: Adenocarcinomas located at the gastro-esophageal junction were associated with Barrett's metaplasia in nearly one half of the patients. The length of the Barrett segment tends to be short and may be missed during endoscopy. The presence of high-grade dysplasia within Barrett's mucosa supports a Barrett's origin for half of the adenocarcinomas arising at this location.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 609-614 |
| Number of pages | 6 |
| Journal | Archives of Surgery |
| Volume | 129 |
| Issue number | 6 |
| State | Published - 1994 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
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Is Barrett's metaplasia the source of adenocarcinomas of the cardia? / Clark, G. W B; Smyrk, Thomas Christopher; Burdiles, P.; Hoeft, S. F.; Peters, J. H.; Kiyabu, M.; Hinder, R. A.; Bremner, C. G.; DeMeester, T. R.
In: Archives of Surgery, Vol. 129, No. 6, 1994, p. 609-614.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Is Barrett's metaplasia the source of adenocarcinomas of the cardia?
AU - Clark, G. W B
AU - Smyrk, Thomas Christopher
AU - Burdiles, P.
AU - Hoeft, S. F.
AU - Peters, J. H.
AU - Kiyabu, M.
AU - Hinder, R. A.
AU - Bremner, C. G.
AU - DeMeester, T. R.
PY - 1994
Y1 - 1994
N2 - Objective: To investigate the prevalence of Barrett's esophagus in patients with adenocarcinomas located at the gastroesophageal junction. Design: A case series of patients who underwent esophagogastrectomy for adenocarcinoma was retrospectively reviewed. Tumors were grouped by location as esophageal, cardiac, and subcardiac, and the prevalence of specialized intestinal metaplasia in the histological specimens was determined. Setting: A university department of surgery that specializes in esophageal diseases. Patients: One hundred patients with adenocarcinoma of the esophagus, cardia, or proximal stomach. Main Outcome: Cardiac adenocarcinomas were associated with Barrett's esophagus in 42% of the patients. Results: Specialized intestinal metaplasia was identified in the histological sections from the resected specimen in 42% (13/31) of cardiac adenocarcinomas and in 79% (38/48) of esophageal adenocarcinomas but in only 5% (1/21) of subcardiac adenocarcinomas. The preoperative endoscopic biopsy results concurred with the final diagnosis of Barrett's esophagus in 33 of the 38 esophageal tumors, six of the 13 cardiac tumors, and the one subcardiac tumor but failed to detect specialized intestinal metaplasia in 54% (7/13) of cardiac tumors. Cardiac tumors were associated with shorter lengths of Barrett's mucosa than esophageal tumors (2.7 ± 1.8 cm vs 7.4 ± 3.4 cm, P<.01). The Barrett's metaplasia was dysplastic in 36 of the 38 esophageal tumors, 10 of the 13 cardiac tumors, but not in the subcardiac tumor. Conclusions: Adenocarcinomas located at the gastro-esophageal junction were associated with Barrett's metaplasia in nearly one half of the patients. The length of the Barrett segment tends to be short and may be missed during endoscopy. The presence of high-grade dysplasia within Barrett's mucosa supports a Barrett's origin for half of the adenocarcinomas arising at this location.
AB - Objective: To investigate the prevalence of Barrett's esophagus in patients with adenocarcinomas located at the gastroesophageal junction. Design: A case series of patients who underwent esophagogastrectomy for adenocarcinoma was retrospectively reviewed. Tumors were grouped by location as esophageal, cardiac, and subcardiac, and the prevalence of specialized intestinal metaplasia in the histological specimens was determined. Setting: A university department of surgery that specializes in esophageal diseases. Patients: One hundred patients with adenocarcinoma of the esophagus, cardia, or proximal stomach. Main Outcome: Cardiac adenocarcinomas were associated with Barrett's esophagus in 42% of the patients. Results: Specialized intestinal metaplasia was identified in the histological sections from the resected specimen in 42% (13/31) of cardiac adenocarcinomas and in 79% (38/48) of esophageal adenocarcinomas but in only 5% (1/21) of subcardiac adenocarcinomas. The preoperative endoscopic biopsy results concurred with the final diagnosis of Barrett's esophagus in 33 of the 38 esophageal tumors, six of the 13 cardiac tumors, and the one subcardiac tumor but failed to detect specialized intestinal metaplasia in 54% (7/13) of cardiac tumors. Cardiac tumors were associated with shorter lengths of Barrett's mucosa than esophageal tumors (2.7 ± 1.8 cm vs 7.4 ± 3.4 cm, P<.01). The Barrett's metaplasia was dysplastic in 36 of the 38 esophageal tumors, 10 of the 13 cardiac tumors, but not in the subcardiac tumor. Conclusions: Adenocarcinomas located at the gastro-esophageal junction were associated with Barrett's metaplasia in nearly one half of the patients. The length of the Barrett segment tends to be short and may be missed during endoscopy. The presence of high-grade dysplasia within Barrett's mucosa supports a Barrett's origin for half of the adenocarcinomas arising at this location.
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UR - http://www.scopus.com/inward/citedby.url?scp=0028365812&partnerID=8YFLogxK
M3 - Article
C2 - 8204035
AN - SCOPUS:0028365812
VL - 129
SP - 609
EP - 614
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 6
ER -