Esophageal Cancer and Barrett's Esophagus
Herausgeber: Sharma, Prateek; Ilson, David; Sampliner, Richard
Esophageal Cancer and Barrett's Esophagus
Herausgeber: Sharma, Prateek; Ilson, David; Sampliner, Richard
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Esophageal Cancer and Barrett's Esophagus, 3E, focuses on these two common and key conditions that affect the esophagus, providing expert guidance to their pathogenesis, cause, prevention, diagnosis and clinical management. Top international names in the field examine each of the many issues involved, using the very latest evidence-based research, and clear, didactic advice allows the reader to understand the best methods of diagnosis and clinical management of each condition - whether early or late stage. Well-illustrated and fully revised to include the latest in ACG/ASG/UEGW guidelines, it…mehr
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Esophageal Cancer and Barrett's Esophagus, 3E, focuses on these two common and key conditions that affect the esophagus, providing expert guidance to their pathogenesis, cause, prevention, diagnosis and clinical management. Top international names in the field examine each of the many issues involved, using the very latest evidence-based research, and clear, didactic advice allows the reader to understand the best methods of diagnosis and clinical management of each condition - whether early or late stage. Well-illustrated and fully revised to include the latest in ACG/ASG/UEGW guidelines, it is the perfect consultation tool for gastroenterologists and oncologists managing patients with cancer of the esophagus. It is also ideal for teaching residents and fellows optimum patient management, and for identifying areas requiring future research.
Produktdetails
- Produktdetails
- Verlag: John Wiley & Sons / Wiley
- 3rd Revised edition
- Seitenzahl: 304
- Erscheinungstermin: 2. November 2015
- Englisch
- Abmessung: 249mm x 191mm x 20mm
- Gewicht: 862g
- ISBN-13: 9781118655207
- ISBN-10: 1118655206
- Artikelnr.: 42339616
- Verlag: John Wiley & Sons / Wiley
- 3rd Revised edition
- Seitenzahl: 304
- Erscheinungstermin: 2. November 2015
- Englisch
- Abmessung: 249mm x 191mm x 20mm
- Gewicht: 862g
- ISBN-13: 9781118655207
- ISBN-10: 1118655206
- Artikelnr.: 42339616
PROFESSOR PRATEEK SHARMA, Professor Medicine, University of Kansas School of Medicine and Veterans Affairs Medical Center, Kansas City, Missouri, and Southern Arizona Veterans Affairs Health Care System and Arizona Health Sciences Center, Tucson, Arizona, USA. PROFESSOR RICHARD SAMPLINER, Professor of Medicine at the University of Arizona, Tucson, AZ, USA, and Chief of Gastroenterology at the Southern Arizona VA Health Care System. DAVID ILSON, MD, PHD, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
List of contributors ix Preface xiii 1 Epidemiology of esophageal carcinoma
1 Mohammad H. Shakhatreh and Hashem B El-Serag 1.1 The incidence and
mortality related to esophageal cancer 1 1.2 Mortality 2 1.3 Risk factors
for EA 2 2 Barrett's esophagus: definition and diagnosis 15 Stuart Jon
Spechler 2.1 Introduction 15 2.2 Early history of Barrett's esophagus 15
2.3 Early reports on the histology of Barrett's esophagus 16 2.4
Identification of the gastroesophageal junction 16 2.5 Recognition of short
segment Barrett's esophagus 17 2.6 Intestinal metaplasia and adenocarcinoma
of the esophagus 18 2.7 The problem of cardiac mucosa 18 2.8 Definition of
Barrett's esophagus 19 2.9 Diagnostic criteria for Barrett's esophagus 19
2.10 Intestinal metaplasia at the GEJ 20 3 Epidemiology and prevalence of
Barrett's esophagus 25 Helen G. Coleman, Shivaram K. Bhat and Liam J.
Murray 3.1 Introduction 25 3.2 BE prevalence 25 3.3 BE incidence 28 3.4
Etiology and risk factors for BE 30 3.5 Neoplastic progression risk in BE
30 3.6 Conclusions 31 4 Esophageal adenocarcinoma: risk factors 35 Mariam
Naveed and Kerry B. Dunbar 4.1 Introduction 35 4.2 Gastroesophageal reflux
disease (GERD) 35 4.3 Barrett's esophagus (BE) 36 4.4 Obesity 37 4.5
Smoking 37 4.6 Alcohol 38 4.7 Dietary factors 38 4.8 Medication use 38 4.9
H. pylori 39 4.10 Demographics 39 4.11 Summary 39 5 Esophageal motility
abnormalities in Barrett's esophagus 45 Kumar Krishnan, John E. Pandolfino
and Peter J. Kahrilas 5.1 Introduction 45 5.2 Antireflux barrier 45 5.3
Lower esophageal sphincter 46 5.4 Diaphragmatic sphincter and hiatal hernia
46 5.5 Mechanical properties of the relaxed EGJ 47 5.6 Esophageal clearance
48 5.7 Peristaltic dysfunction 49 5.8 Gastric emptying and
duodenogastroesophageal reflux 49 5.9 Therapy of motor abnormalities in
Barrett's esophagus 50 5.10 Conclusion 50 6 Molecular biology of Barrett's
esophagus and esophageal adenocarcinoma 55 Ayesha Noorani and Rebecca C.
Fitzgerald 6.1 Introduction 55 6.2 Genetic and host susceptibility 55 6.3
Environmental factors contributing to the development of BE 57 6.4 Genomic
instability mutations and copy number changes in candidate genes 58 6.5 The
advent of next generation sequencing 61 6.6 Future directions and
conclusions 63 7 Histology of Barrett's esophagus: metaplasia and dysplasia
69 Deepa T. Patil and John R. Goldblum 7.1 Introduction 69 7.2 Normal
anatomy and histology 69 7.3 Histology of Barrett's esophagus 69 7.4
Intestinal metaplasia of the EGJ 71 7.5 Barrett's esophagus-related
dysplasia 71 7.6 Intramucosal adenocarcinoma (IMC) 72 7.7 Submucosal
adenocarcinoma 73 7.8 Morphologic types of dysplasia 73 7.9 Sampling error
and observer variation in Barrett's esophagus-related dysplasia 74 7.10
Surrogate biomarkers for assessing risk of esophageal adenocarcinoma 74 8
Helicobacter pylori and esophageal neoplasia 79 Arne Kandulski, Marino
Venerito and Peter Malfertheiner 8.1 Introduction 79 8.2 H. pylori
infection - gastritis pattern and gastric physiology with impact on
gastroesophageal reflux disease 79 8.3 Epidemiological studies - GERD
symptoms, erosive esophagitis and H. pylori 80 8.4 H. pylori, Barrett's
esophagus and esophageal adenocarcinoma 81 8.5 H. pylori eradication and
GERD 82 8.6 H. pylori and esophageal squamous cell carcinoma 83 8.7
Conclusions 84 9 Screening and surveillance 87 Sarmed S. Sami and Krish
Ragunath 9.1 Introduction 87 9.2 Screening 87 9.3 Surveillance 90 9.4
Conclusion 93 10 New surface imaging technologies for dysplasia and cancer
detection 97 David F. Boerwinkel, Wouter L. Curvers and Jacques J.G.H.M.
Bergman 10.1 Introduction 97 10.2 Surface imaging in Barrett's esophagus 98
10.3 Surface imaging for esophageal squamous cell carcinoma 103 10.4
Summary 104 11 New cellular imaging technologies for dysplasia and cancer
detection 107 Helmut Neumann and Ralf Kiesslich 11.1 Introduction 107 11.2
Confocal laser endomicroscopy 107 11.3 Endocytoscopy 110 11.4 Optical
coherence tomography 111 11.5 Molecular imaging in Barrett's 112 11.6
Conclusion 112 12 The role of endoscopic ultrasound in esophageal cancer
115 Samad Soudagar and Neil Gupta 12.1 Background 115 12.2 Equipment 115
12.3 Visualized EUS anatomy 115 12.4 Obstacles to accurate EUS staging 116
12.5 Esophageal cancer staging and impact on treatment intervention 117
12.6 T staging 117 12.7 N staging 119 12.8 M staging 120 12.9 Restaging
after chemoradiotherapy and surveillance for disease recurrence 120 12.10
Conclusion/summary 121 13 Staging of esophageal adenocarcinoma by CT, PET,
and other modalities 125 Florian Lordick, Katja Ott, Matthias Ebert, Lars
Grenacher, Bernd-Joachim Krause and Christian Wittekind 13.1 Introduction
125 13.2 Endoscopic staging 125 13.3 Staging by external ultrasonography
128 13.4 Staging by radiological examinations 128 13.5 Staging by positron
emission tomography (PET) 129 13.6 The value of FDG-PET to predict response
to pre-operative treatment 130 13.7 Conclusion: summary of recommended
staging procedures 132 14 Medical management of Barrett's esophagus 137
Sachin Wani 14.1 Introduction 137 14.2 Assessment of symptoms 137 14.3 Acid
suppressive therapies in management of reflux symptoms 138 14.4
Normalization of intraesophageal acid exposure 138 14.5 Management of
erosive esophagitis 139 14.6 Maintenance of healed mucosa after endoscopic
eradication therapies 139 14.7 Conclusions 140 15 Thermal therapies and
photodynamic therapy for early esophageal neoplasia 143 Jacques Deviere
15.1 Introduction 143 15.2 Photodynamic therapy 144 15.3 Argon plasma
coagulation 144 15.4 Cryotherapy 147 15.5 Conclusion 147 16 RFA for early
esophageal neoplasia 151 Daniel K. Chan, Cadman L. Leggett and Kenneth K.
Wang 16.1 Background 151 16.2 Device and procedural technique 151 16.3
Efficacy and durability of radiofrequency ablation 154 16.4 Initial
treatment response to RFA and risk factors for failed ablation 156 16.5
Endoscopic mucosal resection in combination with radiofrequency ablation
157 16.6 Safety and tolerability of radiofrequency ablation 157 16.7
Subsquamous intestinal metaplasia after radiofrequency ablation 157 16.8
Surveillance following radiofrequency ablation 158 16.9 Conclusions 158 17
The role of endoscopic cryotherapy for treatment and palliation 161 Kristle
Lee Lynch, Eun Ji Shin and Marcia Irene Canto 17.1 Introduction 161 17.2
Cryotherapy mechanisms of tissue injury 161 17.3 Types of cryotherapy:
devices, dosing, and endoscopic application 162 17.4 Efficacy and safety in
Barrett's esophagus 164 17.5 Cryotherapy for the treatment of esophageal
carcinoma 166 17.6 Summary and future directions 167 18 Endoscopic
resection 169 Oliver Pech 18.1 Introduction 169 18.2 ER techniques 169 18.3
ER in HGIN and early Barrett's cancer 171 18.4 ER of submucosal Barrett's
adenocarcinoma 174 18.5 Conclusions 174 19 Endoscopic submucosal dissection
177 Hironori Yamamoto, Tsuneo Oyama and Takuji Gotoda 19.1 Introduction 177
19.2 Indications of ESD for esophageal cancer 177 19.3 Preoperative
examination 178 19.4 Techniques of ESD [19-22] for esophageal cancer 178
19.5 Complications 184 19.6 Sedation and anesthesia 185 19.7 Results 185
19.8 Training 185 19.9 Conclusion 186 20 Surgical therapy of early
esophageal cancer 189 Toshitaka Hoppo and Blair A. Jobe 20.1 Introduction
189 20.2 "Early" esophageal cancer 189 20.3 Indication of surgical
resection for early esophageal adenocarcinoma 190 20.4 Strategy of surgical
resection for early esophageal adenocarcinoma 190 20.5 Choice of surgical
approach and outcomes 191 20.6 Discussion 194 20.7 Conclusion 195 21
Chemoprevention: can we prevent esophageal cancer? 199 Janusz Jankowski and
Mary Denholm 21.1 Overview 199 21.2 The effect of aspirin on cancer
prevention 200 21.3 Risks and adverse effects of aspirin 201 21.4 The role
of aspirin in reflux disease 203 21.5 Risk-benefits of aspirin 204 21.6
AspECT trial 205 22 Selection of patients for cancer prevention and
eradication 209 Aaron J. Small and Gary W. Falk 22.1 Introduction 209 22.2
Patient factors 209 22.3 Cancer risk and grade of dysplasia 210 22.4
Baseline quality measures 212 22.5 The lesion 213 22.6 Predictors of
response 215 22.7 Predictors of initial response to therapy 215 22.8 Future
considerations 217 22.9 Conclusions 217 23 Combined modality therapy in
locally advanced esophageal cancer 221 Geoffrey Y. Ku and David H. Ilson
23.1 Introduction 221 23.2 Pre-operative chemotherapy 221 23.3
Post-operative therapy 222 23.4 Chemoradiation for medically inoperably
patients 224 23.5 Pre-operative chemoradiation 224 23.6 Pre-operative
chemoradiation vs. chemotherapy 225 23.7 Definitive vs. pre-operative
chemoradiation 225 23.8 Newer chemoradiation regimens 226 23.9 Targeted
therapies 226 23.10 Positron emission tomography-directed therapy 227 23.11
Conclusion 228 24 Surgery in locally advanced esophageal cancer 231 Nabil
Rizk 24.1 Introduction 231 24.2 Chemotherapy, chemoradiation and surgical
complications 231 24.3 Technical considerations 232 24.4 Risks of salvage
surgery 233 24.5 Conclusion 234 25 Radiation therapy for locally advanced
esophageal cancer 237 Heath D. Skinner and Bruce D. Minsky 25.1
Introduction 237 25.2 Definitive therapy in unresectable locally advanced
esophageal cancer 237 25.3 Trimodality therapy 240 25.4 Techniques of
radiation therapy 243 25.5 Conclusions 245 26 Systemic therapy and targeted
agents in advanced esophageal cancer 251 Mark A. Lewis and Harry H. Yoon
26.1 Introduction 251 26.2 Chemotherapy 251 26.3 Targeted therapy 253 26.4
Future directions 258 26.5 Conclusions 259 27 Role of endoscopy and
nutritional support in advanced esophageal cancer 265 Manol Jovani, Andrea
Anderloni and Alessandro Repici 27.1 Introduction 265 27.2 Nutritional
support in advanced esophageal cancer 266 27.3 Palliative endoscopy in
inoperable esophageal cancer 266 27.4 Conclusion 273 Index 277
1 Mohammad H. Shakhatreh and Hashem B El-Serag 1.1 The incidence and
mortality related to esophageal cancer 1 1.2 Mortality 2 1.3 Risk factors
for EA 2 2 Barrett's esophagus: definition and diagnosis 15 Stuart Jon
Spechler 2.1 Introduction 15 2.2 Early history of Barrett's esophagus 15
2.3 Early reports on the histology of Barrett's esophagus 16 2.4
Identification of the gastroesophageal junction 16 2.5 Recognition of short
segment Barrett's esophagus 17 2.6 Intestinal metaplasia and adenocarcinoma
of the esophagus 18 2.7 The problem of cardiac mucosa 18 2.8 Definition of
Barrett's esophagus 19 2.9 Diagnostic criteria for Barrett's esophagus 19
2.10 Intestinal metaplasia at the GEJ 20 3 Epidemiology and prevalence of
Barrett's esophagus 25 Helen G. Coleman, Shivaram K. Bhat and Liam J.
Murray 3.1 Introduction 25 3.2 BE prevalence 25 3.3 BE incidence 28 3.4
Etiology and risk factors for BE 30 3.5 Neoplastic progression risk in BE
30 3.6 Conclusions 31 4 Esophageal adenocarcinoma: risk factors 35 Mariam
Naveed and Kerry B. Dunbar 4.1 Introduction 35 4.2 Gastroesophageal reflux
disease (GERD) 35 4.3 Barrett's esophagus (BE) 36 4.4 Obesity 37 4.5
Smoking 37 4.6 Alcohol 38 4.7 Dietary factors 38 4.8 Medication use 38 4.9
H. pylori 39 4.10 Demographics 39 4.11 Summary 39 5 Esophageal motility
abnormalities in Barrett's esophagus 45 Kumar Krishnan, John E. Pandolfino
and Peter J. Kahrilas 5.1 Introduction 45 5.2 Antireflux barrier 45 5.3
Lower esophageal sphincter 46 5.4 Diaphragmatic sphincter and hiatal hernia
46 5.5 Mechanical properties of the relaxed EGJ 47 5.6 Esophageal clearance
48 5.7 Peristaltic dysfunction 49 5.8 Gastric emptying and
duodenogastroesophageal reflux 49 5.9 Therapy of motor abnormalities in
Barrett's esophagus 50 5.10 Conclusion 50 6 Molecular biology of Barrett's
esophagus and esophageal adenocarcinoma 55 Ayesha Noorani and Rebecca C.
Fitzgerald 6.1 Introduction 55 6.2 Genetic and host susceptibility 55 6.3
Environmental factors contributing to the development of BE 57 6.4 Genomic
instability mutations and copy number changes in candidate genes 58 6.5 The
advent of next generation sequencing 61 6.6 Future directions and
conclusions 63 7 Histology of Barrett's esophagus: metaplasia and dysplasia
69 Deepa T. Patil and John R. Goldblum 7.1 Introduction 69 7.2 Normal
anatomy and histology 69 7.3 Histology of Barrett's esophagus 69 7.4
Intestinal metaplasia of the EGJ 71 7.5 Barrett's esophagus-related
dysplasia 71 7.6 Intramucosal adenocarcinoma (IMC) 72 7.7 Submucosal
adenocarcinoma 73 7.8 Morphologic types of dysplasia 73 7.9 Sampling error
and observer variation in Barrett's esophagus-related dysplasia 74 7.10
Surrogate biomarkers for assessing risk of esophageal adenocarcinoma 74 8
Helicobacter pylori and esophageal neoplasia 79 Arne Kandulski, Marino
Venerito and Peter Malfertheiner 8.1 Introduction 79 8.2 H. pylori
infection - gastritis pattern and gastric physiology with impact on
gastroesophageal reflux disease 79 8.3 Epidemiological studies - GERD
symptoms, erosive esophagitis and H. pylori 80 8.4 H. pylori, Barrett's
esophagus and esophageal adenocarcinoma 81 8.5 H. pylori eradication and
GERD 82 8.6 H. pylori and esophageal squamous cell carcinoma 83 8.7
Conclusions 84 9 Screening and surveillance 87 Sarmed S. Sami and Krish
Ragunath 9.1 Introduction 87 9.2 Screening 87 9.3 Surveillance 90 9.4
Conclusion 93 10 New surface imaging technologies for dysplasia and cancer
detection 97 David F. Boerwinkel, Wouter L. Curvers and Jacques J.G.H.M.
Bergman 10.1 Introduction 97 10.2 Surface imaging in Barrett's esophagus 98
10.3 Surface imaging for esophageal squamous cell carcinoma 103 10.4
Summary 104 11 New cellular imaging technologies for dysplasia and cancer
detection 107 Helmut Neumann and Ralf Kiesslich 11.1 Introduction 107 11.2
Confocal laser endomicroscopy 107 11.3 Endocytoscopy 110 11.4 Optical
coherence tomography 111 11.5 Molecular imaging in Barrett's 112 11.6
Conclusion 112 12 The role of endoscopic ultrasound in esophageal cancer
115 Samad Soudagar and Neil Gupta 12.1 Background 115 12.2 Equipment 115
12.3 Visualized EUS anatomy 115 12.4 Obstacles to accurate EUS staging 116
12.5 Esophageal cancer staging and impact on treatment intervention 117
12.6 T staging 117 12.7 N staging 119 12.8 M staging 120 12.9 Restaging
after chemoradiotherapy and surveillance for disease recurrence 120 12.10
Conclusion/summary 121 13 Staging of esophageal adenocarcinoma by CT, PET,
and other modalities 125 Florian Lordick, Katja Ott, Matthias Ebert, Lars
Grenacher, Bernd-Joachim Krause and Christian Wittekind 13.1 Introduction
125 13.2 Endoscopic staging 125 13.3 Staging by external ultrasonography
128 13.4 Staging by radiological examinations 128 13.5 Staging by positron
emission tomography (PET) 129 13.6 The value of FDG-PET to predict response
to pre-operative treatment 130 13.7 Conclusion: summary of recommended
staging procedures 132 14 Medical management of Barrett's esophagus 137
Sachin Wani 14.1 Introduction 137 14.2 Assessment of symptoms 137 14.3 Acid
suppressive therapies in management of reflux symptoms 138 14.4
Normalization of intraesophageal acid exposure 138 14.5 Management of
erosive esophagitis 139 14.6 Maintenance of healed mucosa after endoscopic
eradication therapies 139 14.7 Conclusions 140 15 Thermal therapies and
photodynamic therapy for early esophageal neoplasia 143 Jacques Deviere
15.1 Introduction 143 15.2 Photodynamic therapy 144 15.3 Argon plasma
coagulation 144 15.4 Cryotherapy 147 15.5 Conclusion 147 16 RFA for early
esophageal neoplasia 151 Daniel K. Chan, Cadman L. Leggett and Kenneth K.
Wang 16.1 Background 151 16.2 Device and procedural technique 151 16.3
Efficacy and durability of radiofrequency ablation 154 16.4 Initial
treatment response to RFA and risk factors for failed ablation 156 16.5
Endoscopic mucosal resection in combination with radiofrequency ablation
157 16.6 Safety and tolerability of radiofrequency ablation 157 16.7
Subsquamous intestinal metaplasia after radiofrequency ablation 157 16.8
Surveillance following radiofrequency ablation 158 16.9 Conclusions 158 17
The role of endoscopic cryotherapy for treatment and palliation 161 Kristle
Lee Lynch, Eun Ji Shin and Marcia Irene Canto 17.1 Introduction 161 17.2
Cryotherapy mechanisms of tissue injury 161 17.3 Types of cryotherapy:
devices, dosing, and endoscopic application 162 17.4 Efficacy and safety in
Barrett's esophagus 164 17.5 Cryotherapy for the treatment of esophageal
carcinoma 166 17.6 Summary and future directions 167 18 Endoscopic
resection 169 Oliver Pech 18.1 Introduction 169 18.2 ER techniques 169 18.3
ER in HGIN and early Barrett's cancer 171 18.4 ER of submucosal Barrett's
adenocarcinoma 174 18.5 Conclusions 174 19 Endoscopic submucosal dissection
177 Hironori Yamamoto, Tsuneo Oyama and Takuji Gotoda 19.1 Introduction 177
19.2 Indications of ESD for esophageal cancer 177 19.3 Preoperative
examination 178 19.4 Techniques of ESD [19-22] for esophageal cancer 178
19.5 Complications 184 19.6 Sedation and anesthesia 185 19.7 Results 185
19.8 Training 185 19.9 Conclusion 186 20 Surgical therapy of early
esophageal cancer 189 Toshitaka Hoppo and Blair A. Jobe 20.1 Introduction
189 20.2 "Early" esophageal cancer 189 20.3 Indication of surgical
resection for early esophageal adenocarcinoma 190 20.4 Strategy of surgical
resection for early esophageal adenocarcinoma 190 20.5 Choice of surgical
approach and outcomes 191 20.6 Discussion 194 20.7 Conclusion 195 21
Chemoprevention: can we prevent esophageal cancer? 199 Janusz Jankowski and
Mary Denholm 21.1 Overview 199 21.2 The effect of aspirin on cancer
prevention 200 21.3 Risks and adverse effects of aspirin 201 21.4 The role
of aspirin in reflux disease 203 21.5 Risk-benefits of aspirin 204 21.6
AspECT trial 205 22 Selection of patients for cancer prevention and
eradication 209 Aaron J. Small and Gary W. Falk 22.1 Introduction 209 22.2
Patient factors 209 22.3 Cancer risk and grade of dysplasia 210 22.4
Baseline quality measures 212 22.5 The lesion 213 22.6 Predictors of
response 215 22.7 Predictors of initial response to therapy 215 22.8 Future
considerations 217 22.9 Conclusions 217 23 Combined modality therapy in
locally advanced esophageal cancer 221 Geoffrey Y. Ku and David H. Ilson
23.1 Introduction 221 23.2 Pre-operative chemotherapy 221 23.3
Post-operative therapy 222 23.4 Chemoradiation for medically inoperably
patients 224 23.5 Pre-operative chemoradiation 224 23.6 Pre-operative
chemoradiation vs. chemotherapy 225 23.7 Definitive vs. pre-operative
chemoradiation 225 23.8 Newer chemoradiation regimens 226 23.9 Targeted
therapies 226 23.10 Positron emission tomography-directed therapy 227 23.11
Conclusion 228 24 Surgery in locally advanced esophageal cancer 231 Nabil
Rizk 24.1 Introduction 231 24.2 Chemotherapy, chemoradiation and surgical
complications 231 24.3 Technical considerations 232 24.4 Risks of salvage
surgery 233 24.5 Conclusion 234 25 Radiation therapy for locally advanced
esophageal cancer 237 Heath D. Skinner and Bruce D. Minsky 25.1
Introduction 237 25.2 Definitive therapy in unresectable locally advanced
esophageal cancer 237 25.3 Trimodality therapy 240 25.4 Techniques of
radiation therapy 243 25.5 Conclusions 245 26 Systemic therapy and targeted
agents in advanced esophageal cancer 251 Mark A. Lewis and Harry H. Yoon
26.1 Introduction 251 26.2 Chemotherapy 251 26.3 Targeted therapy 253 26.4
Future directions 258 26.5 Conclusions 259 27 Role of endoscopy and
nutritional support in advanced esophageal cancer 265 Manol Jovani, Andrea
Anderloni and Alessandro Repici 27.1 Introduction 265 27.2 Nutritional
support in advanced esophageal cancer 266 27.3 Palliative endoscopy in
inoperable esophageal cancer 266 27.4 Conclusion 273 Index 277
List of contributors ix Preface xiii 1 Epidemiology of esophageal carcinoma
1 Mohammad H. Shakhatreh and Hashem B El-Serag 1.1 The incidence and
mortality related to esophageal cancer 1 1.2 Mortality 2 1.3 Risk factors
for EA 2 2 Barrett's esophagus: definition and diagnosis 15 Stuart Jon
Spechler 2.1 Introduction 15 2.2 Early history of Barrett's esophagus 15
2.3 Early reports on the histology of Barrett's esophagus 16 2.4
Identification of the gastroesophageal junction 16 2.5 Recognition of short
segment Barrett's esophagus 17 2.6 Intestinal metaplasia and adenocarcinoma
of the esophagus 18 2.7 The problem of cardiac mucosa 18 2.8 Definition of
Barrett's esophagus 19 2.9 Diagnostic criteria for Barrett's esophagus 19
2.10 Intestinal metaplasia at the GEJ 20 3 Epidemiology and prevalence of
Barrett's esophagus 25 Helen G. Coleman, Shivaram K. Bhat and Liam J.
Murray 3.1 Introduction 25 3.2 BE prevalence 25 3.3 BE incidence 28 3.4
Etiology and risk factors for BE 30 3.5 Neoplastic progression risk in BE
30 3.6 Conclusions 31 4 Esophageal adenocarcinoma: risk factors 35 Mariam
Naveed and Kerry B. Dunbar 4.1 Introduction 35 4.2 Gastroesophageal reflux
disease (GERD) 35 4.3 Barrett's esophagus (BE) 36 4.4 Obesity 37 4.5
Smoking 37 4.6 Alcohol 38 4.7 Dietary factors 38 4.8 Medication use 38 4.9
H. pylori 39 4.10 Demographics 39 4.11 Summary 39 5 Esophageal motility
abnormalities in Barrett's esophagus 45 Kumar Krishnan, John E. Pandolfino
and Peter J. Kahrilas 5.1 Introduction 45 5.2 Antireflux barrier 45 5.3
Lower esophageal sphincter 46 5.4 Diaphragmatic sphincter and hiatal hernia
46 5.5 Mechanical properties of the relaxed EGJ 47 5.6 Esophageal clearance
48 5.7 Peristaltic dysfunction 49 5.8 Gastric emptying and
duodenogastroesophageal reflux 49 5.9 Therapy of motor abnormalities in
Barrett's esophagus 50 5.10 Conclusion 50 6 Molecular biology of Barrett's
esophagus and esophageal adenocarcinoma 55 Ayesha Noorani and Rebecca C.
Fitzgerald 6.1 Introduction 55 6.2 Genetic and host susceptibility 55 6.3
Environmental factors contributing to the development of BE 57 6.4 Genomic
instability mutations and copy number changes in candidate genes 58 6.5 The
advent of next generation sequencing 61 6.6 Future directions and
conclusions 63 7 Histology of Barrett's esophagus: metaplasia and dysplasia
69 Deepa T. Patil and John R. Goldblum 7.1 Introduction 69 7.2 Normal
anatomy and histology 69 7.3 Histology of Barrett's esophagus 69 7.4
Intestinal metaplasia of the EGJ 71 7.5 Barrett's esophagus-related
dysplasia 71 7.6 Intramucosal adenocarcinoma (IMC) 72 7.7 Submucosal
adenocarcinoma 73 7.8 Morphologic types of dysplasia 73 7.9 Sampling error
and observer variation in Barrett's esophagus-related dysplasia 74 7.10
Surrogate biomarkers for assessing risk of esophageal adenocarcinoma 74 8
Helicobacter pylori and esophageal neoplasia 79 Arne Kandulski, Marino
Venerito and Peter Malfertheiner 8.1 Introduction 79 8.2 H. pylori
infection - gastritis pattern and gastric physiology with impact on
gastroesophageal reflux disease 79 8.3 Epidemiological studies - GERD
symptoms, erosive esophagitis and H. pylori 80 8.4 H. pylori, Barrett's
esophagus and esophageal adenocarcinoma 81 8.5 H. pylori eradication and
GERD 82 8.6 H. pylori and esophageal squamous cell carcinoma 83 8.7
Conclusions 84 9 Screening and surveillance 87 Sarmed S. Sami and Krish
Ragunath 9.1 Introduction 87 9.2 Screening 87 9.3 Surveillance 90 9.4
Conclusion 93 10 New surface imaging technologies for dysplasia and cancer
detection 97 David F. Boerwinkel, Wouter L. Curvers and Jacques J.G.H.M.
Bergman 10.1 Introduction 97 10.2 Surface imaging in Barrett's esophagus 98
10.3 Surface imaging for esophageal squamous cell carcinoma 103 10.4
Summary 104 11 New cellular imaging technologies for dysplasia and cancer
detection 107 Helmut Neumann and Ralf Kiesslich 11.1 Introduction 107 11.2
Confocal laser endomicroscopy 107 11.3 Endocytoscopy 110 11.4 Optical
coherence tomography 111 11.5 Molecular imaging in Barrett's 112 11.6
Conclusion 112 12 The role of endoscopic ultrasound in esophageal cancer
115 Samad Soudagar and Neil Gupta 12.1 Background 115 12.2 Equipment 115
12.3 Visualized EUS anatomy 115 12.4 Obstacles to accurate EUS staging 116
12.5 Esophageal cancer staging and impact on treatment intervention 117
12.6 T staging 117 12.7 N staging 119 12.8 M staging 120 12.9 Restaging
after chemoradiotherapy and surveillance for disease recurrence 120 12.10
Conclusion/summary 121 13 Staging of esophageal adenocarcinoma by CT, PET,
and other modalities 125 Florian Lordick, Katja Ott, Matthias Ebert, Lars
Grenacher, Bernd-Joachim Krause and Christian Wittekind 13.1 Introduction
125 13.2 Endoscopic staging 125 13.3 Staging by external ultrasonography
128 13.4 Staging by radiological examinations 128 13.5 Staging by positron
emission tomography (PET) 129 13.6 The value of FDG-PET to predict response
to pre-operative treatment 130 13.7 Conclusion: summary of recommended
staging procedures 132 14 Medical management of Barrett's esophagus 137
Sachin Wani 14.1 Introduction 137 14.2 Assessment of symptoms 137 14.3 Acid
suppressive therapies in management of reflux symptoms 138 14.4
Normalization of intraesophageal acid exposure 138 14.5 Management of
erosive esophagitis 139 14.6 Maintenance of healed mucosa after endoscopic
eradication therapies 139 14.7 Conclusions 140 15 Thermal therapies and
photodynamic therapy for early esophageal neoplasia 143 Jacques Deviere
15.1 Introduction 143 15.2 Photodynamic therapy 144 15.3 Argon plasma
coagulation 144 15.4 Cryotherapy 147 15.5 Conclusion 147 16 RFA for early
esophageal neoplasia 151 Daniel K. Chan, Cadman L. Leggett and Kenneth K.
Wang 16.1 Background 151 16.2 Device and procedural technique 151 16.3
Efficacy and durability of radiofrequency ablation 154 16.4 Initial
treatment response to RFA and risk factors for failed ablation 156 16.5
Endoscopic mucosal resection in combination with radiofrequency ablation
157 16.6 Safety and tolerability of radiofrequency ablation 157 16.7
Subsquamous intestinal metaplasia after radiofrequency ablation 157 16.8
Surveillance following radiofrequency ablation 158 16.9 Conclusions 158 17
The role of endoscopic cryotherapy for treatment and palliation 161 Kristle
Lee Lynch, Eun Ji Shin and Marcia Irene Canto 17.1 Introduction 161 17.2
Cryotherapy mechanisms of tissue injury 161 17.3 Types of cryotherapy:
devices, dosing, and endoscopic application 162 17.4 Efficacy and safety in
Barrett's esophagus 164 17.5 Cryotherapy for the treatment of esophageal
carcinoma 166 17.6 Summary and future directions 167 18 Endoscopic
resection 169 Oliver Pech 18.1 Introduction 169 18.2 ER techniques 169 18.3
ER in HGIN and early Barrett's cancer 171 18.4 ER of submucosal Barrett's
adenocarcinoma 174 18.5 Conclusions 174 19 Endoscopic submucosal dissection
177 Hironori Yamamoto, Tsuneo Oyama and Takuji Gotoda 19.1 Introduction 177
19.2 Indications of ESD for esophageal cancer 177 19.3 Preoperative
examination 178 19.4 Techniques of ESD [19-22] for esophageal cancer 178
19.5 Complications 184 19.6 Sedation and anesthesia 185 19.7 Results 185
19.8 Training 185 19.9 Conclusion 186 20 Surgical therapy of early
esophageal cancer 189 Toshitaka Hoppo and Blair A. Jobe 20.1 Introduction
189 20.2 "Early" esophageal cancer 189 20.3 Indication of surgical
resection for early esophageal adenocarcinoma 190 20.4 Strategy of surgical
resection for early esophageal adenocarcinoma 190 20.5 Choice of surgical
approach and outcomes 191 20.6 Discussion 194 20.7 Conclusion 195 21
Chemoprevention: can we prevent esophageal cancer? 199 Janusz Jankowski and
Mary Denholm 21.1 Overview 199 21.2 The effect of aspirin on cancer
prevention 200 21.3 Risks and adverse effects of aspirin 201 21.4 The role
of aspirin in reflux disease 203 21.5 Risk-benefits of aspirin 204 21.6
AspECT trial 205 22 Selection of patients for cancer prevention and
eradication 209 Aaron J. Small and Gary W. Falk 22.1 Introduction 209 22.2
Patient factors 209 22.3 Cancer risk and grade of dysplasia 210 22.4
Baseline quality measures 212 22.5 The lesion 213 22.6 Predictors of
response 215 22.7 Predictors of initial response to therapy 215 22.8 Future
considerations 217 22.9 Conclusions 217 23 Combined modality therapy in
locally advanced esophageal cancer 221 Geoffrey Y. Ku and David H. Ilson
23.1 Introduction 221 23.2 Pre-operative chemotherapy 221 23.3
Post-operative therapy 222 23.4 Chemoradiation for medically inoperably
patients 224 23.5 Pre-operative chemoradiation 224 23.6 Pre-operative
chemoradiation vs. chemotherapy 225 23.7 Definitive vs. pre-operative
chemoradiation 225 23.8 Newer chemoradiation regimens 226 23.9 Targeted
therapies 226 23.10 Positron emission tomography-directed therapy 227 23.11
Conclusion 228 24 Surgery in locally advanced esophageal cancer 231 Nabil
Rizk 24.1 Introduction 231 24.2 Chemotherapy, chemoradiation and surgical
complications 231 24.3 Technical considerations 232 24.4 Risks of salvage
surgery 233 24.5 Conclusion 234 25 Radiation therapy for locally advanced
esophageal cancer 237 Heath D. Skinner and Bruce D. Minsky 25.1
Introduction 237 25.2 Definitive therapy in unresectable locally advanced
esophageal cancer 237 25.3 Trimodality therapy 240 25.4 Techniques of
radiation therapy 243 25.5 Conclusions 245 26 Systemic therapy and targeted
agents in advanced esophageal cancer 251 Mark A. Lewis and Harry H. Yoon
26.1 Introduction 251 26.2 Chemotherapy 251 26.3 Targeted therapy 253 26.4
Future directions 258 26.5 Conclusions 259 27 Role of endoscopy and
nutritional support in advanced esophageal cancer 265 Manol Jovani, Andrea
Anderloni and Alessandro Repici 27.1 Introduction 265 27.2 Nutritional
support in advanced esophageal cancer 266 27.3 Palliative endoscopy in
inoperable esophageal cancer 266 27.4 Conclusion 273 Index 277
1 Mohammad H. Shakhatreh and Hashem B El-Serag 1.1 The incidence and
mortality related to esophageal cancer 1 1.2 Mortality 2 1.3 Risk factors
for EA 2 2 Barrett's esophagus: definition and diagnosis 15 Stuart Jon
Spechler 2.1 Introduction 15 2.2 Early history of Barrett's esophagus 15
2.3 Early reports on the histology of Barrett's esophagus 16 2.4
Identification of the gastroesophageal junction 16 2.5 Recognition of short
segment Barrett's esophagus 17 2.6 Intestinal metaplasia and adenocarcinoma
of the esophagus 18 2.7 The problem of cardiac mucosa 18 2.8 Definition of
Barrett's esophagus 19 2.9 Diagnostic criteria for Barrett's esophagus 19
2.10 Intestinal metaplasia at the GEJ 20 3 Epidemiology and prevalence of
Barrett's esophagus 25 Helen G. Coleman, Shivaram K. Bhat and Liam J.
Murray 3.1 Introduction 25 3.2 BE prevalence 25 3.3 BE incidence 28 3.4
Etiology and risk factors for BE 30 3.5 Neoplastic progression risk in BE
30 3.6 Conclusions 31 4 Esophageal adenocarcinoma: risk factors 35 Mariam
Naveed and Kerry B. Dunbar 4.1 Introduction 35 4.2 Gastroesophageal reflux
disease (GERD) 35 4.3 Barrett's esophagus (BE) 36 4.4 Obesity 37 4.5
Smoking 37 4.6 Alcohol 38 4.7 Dietary factors 38 4.8 Medication use 38 4.9
H. pylori 39 4.10 Demographics 39 4.11 Summary 39 5 Esophageal motility
abnormalities in Barrett's esophagus 45 Kumar Krishnan, John E. Pandolfino
and Peter J. Kahrilas 5.1 Introduction 45 5.2 Antireflux barrier 45 5.3
Lower esophageal sphincter 46 5.4 Diaphragmatic sphincter and hiatal hernia
46 5.5 Mechanical properties of the relaxed EGJ 47 5.6 Esophageal clearance
48 5.7 Peristaltic dysfunction 49 5.8 Gastric emptying and
duodenogastroesophageal reflux 49 5.9 Therapy of motor abnormalities in
Barrett's esophagus 50 5.10 Conclusion 50 6 Molecular biology of Barrett's
esophagus and esophageal adenocarcinoma 55 Ayesha Noorani and Rebecca C.
Fitzgerald 6.1 Introduction 55 6.2 Genetic and host susceptibility 55 6.3
Environmental factors contributing to the development of BE 57 6.4 Genomic
instability mutations and copy number changes in candidate genes 58 6.5 The
advent of next generation sequencing 61 6.6 Future directions and
conclusions 63 7 Histology of Barrett's esophagus: metaplasia and dysplasia
69 Deepa T. Patil and John R. Goldblum 7.1 Introduction 69 7.2 Normal
anatomy and histology 69 7.3 Histology of Barrett's esophagus 69 7.4
Intestinal metaplasia of the EGJ 71 7.5 Barrett's esophagus-related
dysplasia 71 7.6 Intramucosal adenocarcinoma (IMC) 72 7.7 Submucosal
adenocarcinoma 73 7.8 Morphologic types of dysplasia 73 7.9 Sampling error
and observer variation in Barrett's esophagus-related dysplasia 74 7.10
Surrogate biomarkers for assessing risk of esophageal adenocarcinoma 74 8
Helicobacter pylori and esophageal neoplasia 79 Arne Kandulski, Marino
Venerito and Peter Malfertheiner 8.1 Introduction 79 8.2 H. pylori
infection - gastritis pattern and gastric physiology with impact on
gastroesophageal reflux disease 79 8.3 Epidemiological studies - GERD
symptoms, erosive esophagitis and H. pylori 80 8.4 H. pylori, Barrett's
esophagus and esophageal adenocarcinoma 81 8.5 H. pylori eradication and
GERD 82 8.6 H. pylori and esophageal squamous cell carcinoma 83 8.7
Conclusions 84 9 Screening and surveillance 87 Sarmed S. Sami and Krish
Ragunath 9.1 Introduction 87 9.2 Screening 87 9.3 Surveillance 90 9.4
Conclusion 93 10 New surface imaging technologies for dysplasia and cancer
detection 97 David F. Boerwinkel, Wouter L. Curvers and Jacques J.G.H.M.
Bergman 10.1 Introduction 97 10.2 Surface imaging in Barrett's esophagus 98
10.3 Surface imaging for esophageal squamous cell carcinoma 103 10.4
Summary 104 11 New cellular imaging technologies for dysplasia and cancer
detection 107 Helmut Neumann and Ralf Kiesslich 11.1 Introduction 107 11.2
Confocal laser endomicroscopy 107 11.3 Endocytoscopy 110 11.4 Optical
coherence tomography 111 11.5 Molecular imaging in Barrett's 112 11.6
Conclusion 112 12 The role of endoscopic ultrasound in esophageal cancer
115 Samad Soudagar and Neil Gupta 12.1 Background 115 12.2 Equipment 115
12.3 Visualized EUS anatomy 115 12.4 Obstacles to accurate EUS staging 116
12.5 Esophageal cancer staging and impact on treatment intervention 117
12.6 T staging 117 12.7 N staging 119 12.8 M staging 120 12.9 Restaging
after chemoradiotherapy and surveillance for disease recurrence 120 12.10
Conclusion/summary 121 13 Staging of esophageal adenocarcinoma by CT, PET,
and other modalities 125 Florian Lordick, Katja Ott, Matthias Ebert, Lars
Grenacher, Bernd-Joachim Krause and Christian Wittekind 13.1 Introduction
125 13.2 Endoscopic staging 125 13.3 Staging by external ultrasonography
128 13.4 Staging by radiological examinations 128 13.5 Staging by positron
emission tomography (PET) 129 13.6 The value of FDG-PET to predict response
to pre-operative treatment 130 13.7 Conclusion: summary of recommended
staging procedures 132 14 Medical management of Barrett's esophagus 137
Sachin Wani 14.1 Introduction 137 14.2 Assessment of symptoms 137 14.3 Acid
suppressive therapies in management of reflux symptoms 138 14.4
Normalization of intraesophageal acid exposure 138 14.5 Management of
erosive esophagitis 139 14.6 Maintenance of healed mucosa after endoscopic
eradication therapies 139 14.7 Conclusions 140 15 Thermal therapies and
photodynamic therapy for early esophageal neoplasia 143 Jacques Deviere
15.1 Introduction 143 15.2 Photodynamic therapy 144 15.3 Argon plasma
coagulation 144 15.4 Cryotherapy 147 15.5 Conclusion 147 16 RFA for early
esophageal neoplasia 151 Daniel K. Chan, Cadman L. Leggett and Kenneth K.
Wang 16.1 Background 151 16.2 Device and procedural technique 151 16.3
Efficacy and durability of radiofrequency ablation 154 16.4 Initial
treatment response to RFA and risk factors for failed ablation 156 16.5
Endoscopic mucosal resection in combination with radiofrequency ablation
157 16.6 Safety and tolerability of radiofrequency ablation 157 16.7
Subsquamous intestinal metaplasia after radiofrequency ablation 157 16.8
Surveillance following radiofrequency ablation 158 16.9 Conclusions 158 17
The role of endoscopic cryotherapy for treatment and palliation 161 Kristle
Lee Lynch, Eun Ji Shin and Marcia Irene Canto 17.1 Introduction 161 17.2
Cryotherapy mechanisms of tissue injury 161 17.3 Types of cryotherapy:
devices, dosing, and endoscopic application 162 17.4 Efficacy and safety in
Barrett's esophagus 164 17.5 Cryotherapy for the treatment of esophageal
carcinoma 166 17.6 Summary and future directions 167 18 Endoscopic
resection 169 Oliver Pech 18.1 Introduction 169 18.2 ER techniques 169 18.3
ER in HGIN and early Barrett's cancer 171 18.4 ER of submucosal Barrett's
adenocarcinoma 174 18.5 Conclusions 174 19 Endoscopic submucosal dissection
177 Hironori Yamamoto, Tsuneo Oyama and Takuji Gotoda 19.1 Introduction 177
19.2 Indications of ESD for esophageal cancer 177 19.3 Preoperative
examination 178 19.4 Techniques of ESD [19-22] for esophageal cancer 178
19.5 Complications 184 19.6 Sedation and anesthesia 185 19.7 Results 185
19.8 Training 185 19.9 Conclusion 186 20 Surgical therapy of early
esophageal cancer 189 Toshitaka Hoppo and Blair A. Jobe 20.1 Introduction
189 20.2 "Early" esophageal cancer 189 20.3 Indication of surgical
resection for early esophageal adenocarcinoma 190 20.4 Strategy of surgical
resection for early esophageal adenocarcinoma 190 20.5 Choice of surgical
approach and outcomes 191 20.6 Discussion 194 20.7 Conclusion 195 21
Chemoprevention: can we prevent esophageal cancer? 199 Janusz Jankowski and
Mary Denholm 21.1 Overview 199 21.2 The effect of aspirin on cancer
prevention 200 21.3 Risks and adverse effects of aspirin 201 21.4 The role
of aspirin in reflux disease 203 21.5 Risk-benefits of aspirin 204 21.6
AspECT trial 205 22 Selection of patients for cancer prevention and
eradication 209 Aaron J. Small and Gary W. Falk 22.1 Introduction 209 22.2
Patient factors 209 22.3 Cancer risk and grade of dysplasia 210 22.4
Baseline quality measures 212 22.5 The lesion 213 22.6 Predictors of
response 215 22.7 Predictors of initial response to therapy 215 22.8 Future
considerations 217 22.9 Conclusions 217 23 Combined modality therapy in
locally advanced esophageal cancer 221 Geoffrey Y. Ku and David H. Ilson
23.1 Introduction 221 23.2 Pre-operative chemotherapy 221 23.3
Post-operative therapy 222 23.4 Chemoradiation for medically inoperably
patients 224 23.5 Pre-operative chemoradiation 224 23.6 Pre-operative
chemoradiation vs. chemotherapy 225 23.7 Definitive vs. pre-operative
chemoradiation 225 23.8 Newer chemoradiation regimens 226 23.9 Targeted
therapies 226 23.10 Positron emission tomography-directed therapy 227 23.11
Conclusion 228 24 Surgery in locally advanced esophageal cancer 231 Nabil
Rizk 24.1 Introduction 231 24.2 Chemotherapy, chemoradiation and surgical
complications 231 24.3 Technical considerations 232 24.4 Risks of salvage
surgery 233 24.5 Conclusion 234 25 Radiation therapy for locally advanced
esophageal cancer 237 Heath D. Skinner and Bruce D. Minsky 25.1
Introduction 237 25.2 Definitive therapy in unresectable locally advanced
esophageal cancer 237 25.3 Trimodality therapy 240 25.4 Techniques of
radiation therapy 243 25.5 Conclusions 245 26 Systemic therapy and targeted
agents in advanced esophageal cancer 251 Mark A. Lewis and Harry H. Yoon
26.1 Introduction 251 26.2 Chemotherapy 251 26.3 Targeted therapy 253 26.4
Future directions 258 26.5 Conclusions 259 27 Role of endoscopy and
nutritional support in advanced esophageal cancer 265 Manol Jovani, Andrea
Anderloni and Alessandro Repici 27.1 Introduction 265 27.2 Nutritional
support in advanced esophageal cancer 266 27.3 Palliative endoscopy in
inoperable esophageal cancer 266 27.4 Conclusion 273 Index 277