By Simone Giacopuzzi, Andrea Zanoni, Giovanni de Manzoni
This publication deals up to date and complete assurance of the prognosis and remedy of adenocarcinoma of the esophagogastric junction (EGJ). As is acceptable within the period of multidisciplinary and multimodal remedy, the contributions of all of the quite a few experts concerned cooperatively within the remedy of EGJ melanoma are completely defined. particular awareness is additionally paid to the importance of preneoplastic lesions, similar to Barrett esophagus. the ultimate a part of the publication represents a surgical atlas documenting the ideas utilized in the EGJ quarter, with marvelous colour pictures and stepwise description of methods. opposed to the heritage of the swiftly expanding occurrence in EGJ melanoma, in particular glaring in Western nations, there's a desire for higher uniformity in administration ideas, which at the moment fluctuate considerably internationally. This publication offers acceptable advice that might help all practitioners excited about the prognosis and remedy of EGJ cancers, together with surgeons, oncologists, and radiotherapists.
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Additional info for Adenocarcinoma of the Esophagogastric Junction: From Barrett's Esophagus to Cancer
2 Efficacy PDT is the first ablation technique proven to be effective and durable in a randomized controlled trial. 0001) on mean follow-up of 24 months . 0001). There was also a significant difference in progression to cancer, with 13 % of patients in the PDT group developing cancer compared with 28 % in the omeprazole group. Eradication of HGD at 5-year follow-up was achieved in 77 % of those treated with PDT plus omeprazole and 39 % of those treated with omeprazole alone. N. Thota 30 esophageal cancer at 5-year follow-up was 15 % in the PDT group and 29 % in the omeprazole- only arm .
These differences may have several explanations. For instance, some studies did not distinguish between prevalent and incident LGD, but patients with prevalent LGD are more prone to progression . Another reason might be the instability of the LGD phenotype, which may also regress to NDBE after the use of proton pump inhibitors or surgery . LGD is also a patchy condition and biopsies may miss foci of LGD or remove them completely if they are small. Finally, there is a lack of agreement among pathologists, giving rise to a high interand intra-observer variability concerning regenerative or inflammatory tissue that may be misdiagnosed as LGD .
The remission rate varied from 97 to 100 % in patients with esophagectomy and 84 to 97 % in patients with endoscopic treatment. 00). 7 % in the surgery group during follow-up. Most patients died of baseline comorbidities including cardiovascular disease, pulmonary disease, diabetes, and prior malignancy. 3 % in the surgery group. 38). 8–100 %) with neoplasia recurrence underwent endoscopic retreatment and got neoplasia remission again or had stable disease. prevalence of SSIM varies from 0 to 28 % , but this may not be a true estimate as most of the endoscopic biopsies are not adequate to include subepithelial lamina propria .