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Langenbeck's Archives of Surgery

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01-05-2009 | Overview

Reflux esophagitis, high-grade neoplasia, and early Barrett’s carcinoma—what is the place of the Merendino procedure?

Authors: A. H. Hölscher, D. Vallböhmer, C. Gutschow, E. Bollschweiler

Published in: Langenbeck's Archives of Surgery | Issue 3/2009

Abstract

Introduction

Because of the increasing frequency of Barrett’s cancer in Western industrialized countries, the management of reflux disease with the potential development of Barrett’s esophagus, neoplasia, and early carcinoma is very important. In case of established Barrett’s esophagus, the malignant degeneration of the specialized epithelium cannot definitely be prevented by antireflux surgery or continuous medication. Mucosal adenocarcinomas nearly never develop lymph node metastasis and can mostly be treated by endoscopic mucosectomy. The deeper the submucosa is infiltrated, the higher is the rate of lymph node metastasis which is, on the average, 30% for submucosal carcinoma.

Conclusions

Therefore, radical subtotal esophagectomy is the treatment of choice for submucosal carcinoma, whereas distal esophageal resection with limited lymph node dissection is only indicated in mucosal carcinoma which cannot be completely removed by interventional endoscopy.

Bollschweiler E, Knoppe K, Wolfgarten E, Hölscher AH (2007) Prevalence of reflux symptoms in the Cologne normal population. Z Gastroenterol 45:177–181 doi:10.1055/s-2006-927402 PubMedCrossRef

Forgacs I, Loganayagam A (2008) Overprescribing proton pump inhibitors. BMJ 336:2–3 doi:10.1136/bmj.39406.449456.BE PubMedCrossRef

Hölscher AH, Bollschweiler E, Gutschow C (2007) GERD and complications: when is surgery necessary? Z Gastroenterol 45:1150–1155 doi:10.1055/s-2007-963630 PubMedCrossRef

Froelicher P, Miller G (1986) The European experience with esophageal cancer limited to the mucosa and submucosa. Gastrointest Endosc 32:88–90 (95–9)PubMedCrossRef

Bollschweiler E, Wolfgarten E, Gutschow C, Hölscher AH (2001) Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer 92:549–555 doi:10.1002/1097-0142(20010801)92:3<549::AID-CNCR1354>3.0.CO;2-L PubMedCrossRef

Parfitt JR, Miladinovic Z, Driman DK (2006) Increasing incidence of adenocarcinoma of the gastroesophageal junction and distal stomach in Canada—an epidemiological study from 1964 to 2002. Can J Gastroenterol 20:271–276PubMed

Hölscher A, Bollschweiler E, Schneider P, Siewert J (1997) Early adenocarcinoma in Barrett’s oesophagus. Br J Surg 84:1470–1473 doi:10.1002/bjs.1800841035 PubMedCrossRef

Bollschweiler E, Baldus S, Schroeder W, Prenzel K, Gutschow C, Schneider P, Hölscher A (2006) High rate of lymph-node metastasis in submucosal esophageal squamous-cell carcinomas and adenocarcinomas. Endoscopy 38:149–156 doi:10.1055/s-2006-924993 PubMedCrossRef

Spechler SJ (2002) Clinical practice. Barrett’s Esophagus. N Engl J Med 346:836–842 doi:10.1056/NEJMcp012118 PubMedCrossRef

10.

Jankowski JA, Provenzale D, Moayyedi P (2002) Esophageal adenocarcinoma arising from Barrett’s metaplasia has regional variations in the west. Gastroenterology 122:588–590 doi:10.1053/gast.2002.31599 PubMedCrossRef

11.

Solaymani-Dodaran M, Logan RF, West J et al (2004) Risk of oesophageal cancer in Barrett’s oesophagus and gastro-oesophageal reflux. Gut 53:1070–1074 doi:10.1136/gut.2003.028076 PubMedCrossRef

12.

Hage M, Siersema PD, van Dekken H et al (2004) Oesophageal cancer incidence and mortality in patients with long-segment Barrett’s oesophagus after a mean follow-up of 12.7 years. Scand J Gastroenterol 39:1175–1179 doi:10.1080/00365520410003524 PubMedCrossRef

13.

Voutilainen M, Sipponen P, Mecklin JP, Juhola M, Farkkila M (2000) Gastroesophageal reflux disease: prevalence, clinical, endoscopic and histopathological findings in 1,128 consecutive patients referred for endoscopy due to dyspeptic and reflux symptoms. Digestion 61:6–13 doi:10.1159/000007730 PubMedCrossRef

14.

Malfertheiner P, Lind T, Willich S, Vieth M, Jaspersen D, Labenz J, Meyer-Sabellek W, Junghard O, Stolte M (2005) Prognostic influence of Barrett’s esophagus and Helicobacter pylori infection on healing of ertosive gastroesophageal (GORD) and symptom resolution in non-erosive GORD: report from the ProGORD Study. Gut 54:746–751 doi:10.1136/gut.2004.042143 PubMedCrossRef

15.

van Soest E, Dieleman J, Siersema P, Sturkenboom M, Kuipers E (2005) Increasing incidence of Barrett’s oesophagus in the general population. Gut 54:1062–1066 doi:10.1136/gut.2004.063685 PubMedCrossRef

16.

Dent J, El-Serag H, Wallander M, Johansson S (2005) Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 54:710–717 doi:10.1136/gut.2004.051821 PubMedCrossRef

17.

Bardhan KD, Royston C, Nayyar AK (2006) Reflux rising! An essay on witnessing a disease in evolution. Dig Liver Dis 38:163–168 doi:10.1016/j.dld.2005.10.011 PubMedCrossRef

18.

Hanahan D, Weinberg RA (2000) The hallmarks of cancer. Cell 100:57–70 doi:10.1016/S0092-8674(00)81683-9 PubMedCrossRef

19.

Morales CP, Souza RF, Spechler SJ (2002) Hallmarks of cancer progression in Barrett’s oesophagus. Lancet 360:1587–1589 doi:10.1016/S0140-6736(02)11569-8 PubMedCrossRef

20.

Whittles CE, Biddlestone LR, Burton A, Barr H, Jankowski JA, Warner PJ, Shepherd NA (1999) Apoptotic and proliferative activity in the neoplastic progression of Barrett’s oesophagus: a comparative study. J Pathol 187:535–540 doi:10.1002/(SICI)1096-9896(199904)187:5<535::AID-PATH302>3.0.CO;2-G PubMedCrossRef

21.

Klump B, Hsieh CJ, Holzmann K, Gregor M, Porschen R (1998) Hypermethylation of the CDKN2/p16 promoter during neoplastic progression in Barrett’s esophagus. Gastroenterology 115:1381–1386 doi:10.1016/S0016-5085(98)70016-2 PubMedCrossRef

22.

Vallböhmer D, Peters JH, Oh D, Kuramochi H, Shimizu D, Demeester SR, Hagen JA, Chandrasoma PT, Danenberg KD, DeMeester TR, Danenberg P (2005) Survivin, a potential biomarker in the development of Barrett’s adenocarcinoma. Surgery 138:701–706 doi:10.1016/j.surg.2005.06.051 PubMedCrossRef

23.

Morales CP, Lee EL, Shay JW (1998) In situ hybridization for the detection of telomerase RNA in the progression from Barrett’s esophagus to esophageal adenocarcinoma. Cancer 83:652–659 doi:10.1002/(SICI)1097-0142(19980815)83:4<652::AID-CNCR4>3.0.CO;2-M PubMedCrossRef

24.

Vallböhmer D, Peters JH, Kuramochi H, Oh D, Yang D, Shimizu D, DeMeester SR, Hagen JA, Chandrasoma PT, Danenberg KD, Danenberg PV, DeMeester TR (2006) Molecular determinants in targeted therapy for esophageal adenocarcinoma. Arch Surg 141:476–481 doi:10.1001/archsurg.141.5.476 PubMedCrossRef

25.

Salmela MT, Karjalainen-Lindsberg ML, Puolakkainen P, Saarialho-Kere U (2001) Upregulation and differential expression of matrilysin (MMP-7) and metalloelastase (MMP-12) and their inhibitors TIMP-1 and TIMP-3 in Barrett’s oesophageal adenocarcinoma. Br J Cancer 85:383–392 doi:10.1054/bjoc.2001.1929 PubMedCrossRef

26.

Schlemper R, Riddell R, Kato Y, Borchard F, Cooper H, Dawsey S, Dixon M, Fenoglio-Preiser C, Flejou J, Geboes K, Hattori T, Hirota T, Irabashi M, Iwafuchi M, Iwashita A, Kim Y, Kirchner T, Klimpfinger M, Koike M, Lauwers G, Lewin K, Oberhuber G, Offner F, Price A, Rubio C, Shimizu M, Shimoda T, Sipponen P, Solcia E, Stolte M, Watanabe H, Yamabe H (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47:251–255 doi:10.1136/gut.47.2.251 PubMedCrossRef

27.

Dixon M (2002) Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 51:130–131 doi:10.1136/gut.51.1.130 PubMedCrossRef

28.

Rugge M, Cassaro M, Di MF, Leo G, Russo V, Pennelli G, Farinati F (2003) The long term outcome of gastric non-invasive neoplasia. Gut 52:1111–1116 doi:10.1136/gut.52.8.1111 PubMedCrossRef

29.

Tsukuma H, Oshima O, Narahara H, Morii T (2000) Natural history of early gastric cancer: a non-concurrent, long-term follow up study. Gut 47:618–621 doi:10.1136/gut.47.5.618 PubMedCrossRef

30.

Gutschow C, Schröder W, Prenzel K, Bollschweiler E, Romagnoli R, Collard J, Hölscher A (2002) Impact of antireflux surgery on Barrett’s esophagus. Langenbecks Arch Surg 387:138–145 doi:10.1007/s00423-002-0303-0 PubMedCrossRef

31.

Chang E, Morris C, Seltman A, O’Rourke R, Chan B, Hunter J, Jobe B (2007) The effect of antireflux surgery on esophageal carcinogenesis in patients with barrett esophagus: a systematic reviwe. Ann Surg 246:11–21 doi:10.1097/01.sla.0000261459.10565.e9 PubMedCrossRef

32.

Parrilla P, Martinez dHL, Ortiz A, Munitiz V, Molina J, Bermejo J, Canteras M (2003) Long term results of a randomized prospective study comparing medical and surgical treatment of Barret’s esophagus. Ann Surg 237:291–298 doi:10.1097/00000658-200303000-00001 PubMedCrossRef

33.

Rossi M, Barreca M, de Bortoli N, Renzi C, Santi S, Gennai A, Bellini M, Costa F, Conio M, Marchi S (2006) Efficacy of Nissen fundoplication versus medical therapy in the regression of low-grade dysplasia in patients with Barrett esophagus: a prospective study. Ann Surg 243:58–63 doi:10.1097/01.sla.0000194085.56699.db PubMedCrossRef

34.

Liu L, Hofstetter W, Rashid A et al (2005) Significance of the depth of tumor invasion in early (T1) esophageal adenocarcinoma. Mod Pathol 18:110A–110A

35.

Westerterp M, Koppert L, Buskens C et al (2005) Outcome of surgical treatment for early adenocarcinoma of the esophagus or gastro-esophageal junction. Virchows Arch 446:497–504 doi:10.1007/s00428-005-1243-1 PubMedCrossRef

36.

May A, Gunter E, Roth F, Gossner L, Stolte M, Vieth M et al (2004) Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonography: a comparative, prospective, and blinded trial. Gut 53:634–640 doi:10.1136/gut.2003.029421 PubMedCrossRef

37.

Rice T (1999) Superficial oesophagueal carcinoma: is there a need for three-field lymphadenectomy? Lancet 354:792–794PubMed

38.

Shimada H, Nabeya Y, Matsubara H et al (2006) Prediction of lymph node status in patients with superficial esophageal carcinoma: analysis of 160 surgically resected cancers. Am J Surg 191:250–254 doi:10.1016/j.amjsurg.2005.07.035 PubMedCrossRef

39.

Araki K, Ohno S, Egashira A, Saeki H, Kawaguchi H, Sugimachi K (2002) Pathologic features of superficial esohageal squamous cell carcinoma with lymph node and distal metastasis. Cancer 94:570–575 doi:10.1002/cncr.10190 PubMedCrossRef

40.

Endo M, Yoshino K, Kawano T, Nagai K, Inoue H (2000) Clinocopathologic analysis of lymph node metastasis in surgically resected superficial cancer of the thoracic esophagus. Dis Esophagus 13:125–129 doi:10.1046/j.1442-2050.2000.00100.x PubMedCrossRef

41.

Chibana Y, Fujii S, Ichikawa K, Fujita M, Ono Y, Tomita S, Imura J, Kawamata H, Terano A, Fujimori T (2005) Tumor cell dissociation score highly correlates with lymph node metastasis in superficial esophageal carcinoma. J Gastroenterol Hepatol 20:1371–1378 doi:10.1111/j.1440-1746.2005.03858.x PubMedCrossRef

42.

Sato Y, Motoyama S, Maruyama K, Okuyama M, Ogawa J (2005) A second malignancy is the major cause of death among thoracic squamous cell esophageal cancer patients negative for lymph node involvement. J Am Coll Surg 201:188–193 doi:10.1016/j.jamcollsurg.2005.03.013 PubMedCrossRef

43.

van Sandick J, van Lanschot J, ten Kate F, Offerhaus G, Fockens P, Tytgat G et al (2000) Pathology of early invasive adenocarcinoma of the esophagus or esophagogastric junction: implications for therapeutic decision making. Cancer 88:2429–2437 doi:10.1002/1097-0142(20000601)88:11<2429::AID-CNCR1>3.0.CO;2-H PubMedCrossRef

44.

Hagen J, De Meester S, Peters J et al (2001) Curative resection for esophageal adenocarcinoma: analysis of 100 en bloc esophagectomies. Ann Surg 234:520–530 doi:10.1097/00000658-200110000-00011 PubMedCrossRef

45.

Rice T, Blackstone E, Goldblum J et al (2001) Superficial adenocarcinoma of the esophagus. J Thorac Cardiovasc Surg 122:1077–1090 doi:10.1067/mtc.2001.113749 PubMedCrossRef

46.

Stein H, Feith M, von_Rahden B et al (2003) Approach to early Barrett’s cancer. World J Surg 27:1040–1046 doi:10.1007/s00268-003-7059-8 PubMedCrossRef

47.

Oh DS, Hagen JA, T Chandrasoma P et al (2006) Clinical biology and surgical therapy of intramucosal adenocarcinoma of the esophagus. J Am Coll Surg 203:152–161 doi:10.1016/j.jamcollsurg.2006.05.006 PubMedCrossRef

48.

May A, Gossner L, Behrens A, Kohnen R, Vieth M, Stolte M, Ell C (2003) A prospective randomized trial of two different endoscopic resection techniques for early stage cancer of the esophagus. Gastrointest Endosc 58:167–175 doi:10.1067/mge.2003.339 PubMedCrossRef

49.

Ell C, May A, Gossner L, Pech O, Gunter M, Mayer G, Henrich R, Vieth M, Muller H, Seitz G, Stolte M (2000) Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus. Gastroenterology 118:670–677 doi:10.1016/S0016-5085(00)70136-3 PubMedCrossRef

50.

Ell C, May A, Pech O, Gossner L, Gunter E, Behrens A, Nachbar L, Huijsmans J, Vieth M, Stolte M (2007) Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer). Gastrointest Endosc 65:3 doi:10.1016/j.gie.2006.04.033 PubMedCrossRef

51.

Overholt BF, Banjepouhr M, Halberg DL (2003) Photodynamic therapy for Barrett’s esophagus with dysplasia and/or early stage carcinoma: long-term results. Gastrointest Endosc 58:183–188 doi:10.1067/mge.2003.327 PubMedCrossRef

52.

Merendino KA, Dilard DH (1955) The concept of sphincter substitution by an interposed jejunal segment for anatomic and physiologic abnormalities at the esophagogastric junction. Ann Surg 142:486–509PubMedCrossRef

53.

Gutschow C, Schroder W, Wolfgarten E, Holscher A (2004) Merendino procedure with preservation of the vagus for early carcinoma of the gastroesophageal junction. Zentralbl Chir 129:276–281 doi:10.1055/s-2004-820307 PubMedCrossRef

54.

Stein H, Feith M, Mueller J et al (2000) Limited resection for early adenocarcinoma in Barrett’s esophagus. Ann Surg 232:733–742 doi:10.1097/00000658-200012000-00002 PubMedCrossRef

55.

Banki F, Mason RJ, DeMeester SR, Hagen JA, Balaji NS, Crookes PF, Bremner CG, Peters JH, DeMeester TR (2002) Vagal-sparing esophagectomy: a more physiologic alternative. Ann Surg 236:324–336 doi:10.1097/00000658-200209000-00009 PubMedCrossRef

56.

Peyre C, Demeester S, Rizzetto C, Bansal N, Tang A, Ayazi S, Leers J, Lipham J, Hagen J, Demeester T (2007) Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasia. Ann Surg 246:665–674 doi:10.1097/SLA.0b013e318155a7a1 PubMedCrossRef

57.

Hulscher J, van Sandick J, de Boer A et al (2002) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347:1662–1669 doi:10.1056/NEJMoa022343 PubMedCrossRef

58.

van Sandick J, van Lanschot J, ten Kate F et al (2002) Indicators of prognosis after transhiatal esophageal resection without thoracotomy for cancer. J Am Coll Surg 194:28–36 doi:10.1016/S1072-7515(01)01119-X PubMedCrossRef

59.

Hölscher AH (2007) Endoscopic mucosal resection for early squamous cell cancer of the esophagus—a dangerous game or standard treatment. Endoscopy 39:1–3 doi:10.1055/s-2007-966175 CrossRef

Title: Reflux esophagitis, high-grade neoplasia, and early Barrett’s carcinoma—what is the place of the Merendino procedure?
Authors: A. H. Hölscher
D. Vallböhmer
C. Gutschow
E. Bollschweiler
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0429-9

ACC 2024 Congress

Springer Medicine

Reflux esophagitis, high-grade neoplasia, and early Barrett’s carcinoma—what is the place of the Merendino procedure?

Abstract

Introduction

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Introduction

Conclusions

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