1932
0
  1. Home
  2. A-Z Publications
  3. Annual Review of Medicine
  4. Volume 68, 2017
  5. Article

Annual Review of Medicine

Volume 68, 2017

Esophageal Adenocarcinoma: Screening, Surveillance, and Management

Abstract

Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Acid suppression, nonsteroidal antiinflammatory drugs (NSAIDs), and statins may play a role in chemoprevention. Screening for Barrett's esophagus (BE), the only known precursor lesion of EAC, is indicated for individuals with increased risk. Endoscopic surveillance of patients with BE likely improves overall outcomes. Endoscopic ablation and resection is highly effective for treating dysplastic BE and early EAC, whereas esophagectomy is indicated for patients with locally advanced disease. This review covers epidemiology, staging, screening, and prevention of EAC as well as endoscopic and surgical management.

Keyword(s): advanced endoscopic imaging, Barrett's esophagus, chemoprevention, endoscopic eradication therapy, screening, surveillance
Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-050715-104218
2017-01-14
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/med/68/1/annurev-med-050715-104218.html?itemId=/content/journals/10.1146/annurev-med-050715-104218&mimeType=html&fmt=ahah

Literature Cited

  1. Howlader N, Noone AM, Krapcho M. 1.  et al. 2016. SEER Cancer Statistics Review, 1975–2013. Bethesda, MD: Natl. Cancer Inst. http://seer.cancer.gov/csr/1975_2013/
  2. Bosch A, Frias Z, Caldwell WL. 2.  1979. Adenocarcinoma of the esophagus. Cancer 4341557–61
  3. Abrams JA, Sharaiha RZ, Gonsalves L. 3.  et al. 2011. Dating the rise of esophageal adenocarcinoma: analysis of Connecticut Tumor Registry data, 1940–2007. Cancer Epidemiol. Biomark. Prev. 201183–85
  4. Pera M, Manterola C, Vidal O. 4.  et al. 2005. Epidemiology of esophageal adenocarcinoma. J. Surg. Oncol. 923151–59
  5. Bosetti C, Levi F, Ferlay J. 5.  et al. 2008. Trends in oesophageal cancer incidence and mortality in Europe. Int. J. Cancer 12251118–29
  6. Lepage C, Drouillard A, Jouve J-L. 6.  et al. 2013. Epidemiology and risk factors for oesophageal adenocarcinoma. Dig. Liver Dis. 458625–29
  7. Lord RV, Law MG, Ward RL. 7.  et al. 1998. Rising incidence of oesophageal adenocarcinoma in men in Australia. J. Gastroenterol. Hepatol. 134356–62
  8. Arnold M, Soerjomataram I, Ferlay J. 8.  et al. 2015. Global incidence of oesophageal cancer by histological subtype in 2012. Gut 643381–87
  9. Runge TM, Abrams JA, Shaheen NJ. 9.  2015. Epidemiology of Barrett's esophagus and esophageal adenocarcinoma. Gastroenterol. Clin. North Am. 442203–31
  10. Nordenstedt H, El-Serag H. 10.  2011. The influence of age, sex, and race on the incidence of esophageal cancer in the United States (1992–2006). Scand. J. Gastroenterol. 46:5597–602 [Google Scholar]
  11. Pohl H, Welch HG. 11.  2005. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J. Natl. Cancer Inst. 972142–46
  12. Lagergren J, Bergström R, Lindgren A. 12.  et al. 1999. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N. Engl. J. Med. 34011825–31
  13. Rubenstein JH, Taylor JB. 13.  2010. Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux. Aliment. Pharmacol. Ther. 32101222–27
  14. Guillem PG. 14.  2005. How to make a Barrett esophagus: pathophysiology of columnar metaplasia of the esophagus. Dig. Dis. Sci. 503415–24
  15. Sharma P, Falk GW, Weston AP. 15.  et al. 2006. Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus. Clin. Gastroenterol. Hepatol. 45566–72
  16. Hvid-Jensen F, Pedersen L, Drewes AM. 16.  et al. 2011. Incidence of adenocarcinoma among patients with Barrett's esophagus. N. Engl. J. Med. 365151375–83
  17. Shakhatreh MH, Duan Z, Kramer J. 17.  et al. 2014. The incidence of esophageal adenocarcinoma in a national veterans cohort with Barrett's esophagus. Am. J. Gastroenterol. 109121862–68
  18. Kubo A, Corley DA. 18.  2006. Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis. Cancer Epidemiol. Biomark. Prev. 155872–78
  19. Hampel H, Abraham NS, El-Serag HB. 19.  2005. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann. Intern. Med. 1433199–211
  20. Singh S, Sharma AN, Murad MH. 20.  et al. 2013. Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis. Clin. Gastroenterol. Hepatol. 11111399–1412.e7
  21. Xie F-J, Zhang Y-P, Zheng Q-Q. 21.  et al. 2013. Helicobacter pylori infection and esophageal cancer risk: an updated meta-analysis. World J. Gastroenterol. 19366098–107
  22. Fischbach LA, Graham DY, Kramer JR. 22.  et al. 2014. Association between Helicobacter pylori and Barrett's esophagus: a case-control study. Am. J. Gastroenterol. 1093357–68
  23. Tramacere I, La Vecchia C, Negri E. 23.  2011. Tobacco smoking and esophageal and gastric cardia adenocarcinoma: a meta-analysis. Epidemiology 223344–49
  24. Tramacere I, Pelucchi C, Bagnardi V. 24.  et al. 2012. A meta-analysis on alcohol drinking and esophageal and gastric cardia adenocarcinoma risk. Ann. Oncol. 232287–97
  25. Rice TW, Rusch VW, Ishwaran H. 25.  et al. 2010. Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer cancer staging manuals. Cancer 116163763–73
  26. van Vliet EPM, Heijenbrok-Kal MH, Hunink MGM. 26.  et al. 2008. Staging investigations for oesophageal cancer: a meta-analysis. Br. J. Cancer 983547–57
  27. Hasegawa N, Niwa Y, Arisawa T. 27.  et al. 1996. Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography. Gastrointest. Endosc. 444388–93
  28. Catalano MF, Van Dam J, Sivak MV. 28.  1995. Malignant esophageal strictures: staging accuracy of endoscopic ultrasonography. Gastrointest. Endosc. 416535–39
  29. Evans JA, Early DS, Chandraskhara V. 29.  et al. 2013. The role of endoscopy in the assessment and treatment of esophageal cancer. Gastrointest. Endosc. 773328–34
  30. Young PE, Gentry AB, Acosta RD. 30.  et al. 2010. Endoscopic ultrasound does not accurately stage early adenocarcinoma or high-grade dysplasia of the esophagus. Clin. Gastroenterol. Hepatol. 8121037–41
  31. Pouw RE, Heldoorn N, Alvarez Herrero L. 31.  et al. 2011. Do we still need EUS in the workup of patients with early esophageal neoplasia? A retrospective analysis of 131 cases. Gastrointest. Endosc. 734662–68
  32. García Rodríguez LA, Lagergren J, Lindblad M. 32.  2006. Gastric acid suppression and risk of oesophageal and gastric adenocarcinoma: a nested case control study in the UK. Gut 55111538–44
  33. El-Serag HB, Aguirre TV, Davis S. 33.  et al. 2004. Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett's esophagus. Am. J. Gastroenterol. 99101877–83
  34. Kastelein F, Spaander MCW, Steyerberg EW. 34.  et al. 2013. Proton pump inhibitors reduce the risk of neoplastic progression in patients with Barrett's esophagus. Clin. Gastroenterol. Hepatol. 114382–88
  35. Singh S, Garg SK, Singh PP. 35.  et al. 2013. Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus: a systematic review and meta-analysis. Gut 6381229–37
  36. Baruah A, Buttar NS. 36.  2015. Chemoprevention in Barrett's oesophagus. Best Pract. Res. Clin. Gastroenterol. 291151–65
  37. Liao LM, Vaughan TL, Corley DA. 37.  et al. 2012. Nonsteroidal anti-inflammatory drug use reduces risk of adenocarcinomas of the esophagus and esophagogastric junction in a pooled analysis. Gastroenterology 1423442–52.e5
  38. Heath EI, Canto MI, Piantadosi S. 38.  et al. 2007. Secondary chemoprevention of Barrett's esophagus with celecoxib: results of a randomized trial. J. Natl. Cancer Inst. 997545–57
  39. Spechler SJ, Sharma P, Souza RF. 39.  et al. 2011. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology 14031084–91
  40. Shaheen NJ, Falk GW, Iyer PG. 40.  et al. 2016. ACG clinical guideline: diagnosis and management of Barrett's esophagus. Am. J. Gastroenterol. 111130–50
  41. Singh S, Singh AG, Singh PP. 41.  et al. 2013. Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett's esophagus: a systematic review and meta-analysis. Clin. Gastroenterol. Hepatol. 116620–29
  42. Nguyen T, Duan Z, Naik AD. 42.  et al. 2015. Statin use reduces risk of esophageal adenocarcinoma in US veterans with Barrett's esophagus: a nested case-control study. Gastroenterology 14961392–98
  43. di Pietro M, Chan D, Fitzgerald RC. 43.  et al. 2015. Screening for Barrett's esophagus. Gastroenterology 1485912–23
  44. Dulai GS, Guha S, Kahn KL. 44.  et al. 2002. Preoperative prevalence of Barrett's esophagus in esophageal adenocarcinoma: a systematic review. Gastroenterology 122126–33
  45. Cooper GS, Kou TD, Chak A. 45.  2009. Receipt of previous diagnoses and endoscopy and outcome from esophageal adenocarcinoma: a population-based study with temporal trends. Am. J. Gastroenterol. 10461356–62
  46. El-Serag HB, Naik AD, Duan Z. 46.  et al. 2015. Surveillance endoscopy is associated with improved outcomes of oesophageal adenocarcinoma detected in patients with Barrett's oesophagus. Gut 65:81252–60 [Google Scholar]
  47. Canto MI, Anandasabapathy S, Brugge W. 47.  et al. 2014. In vivo endomicroscopy improves detection of Barrett's esophagus-related neoplasia: a multicenter international randomized controlled trial (with video). Gastrointest. Endosc. 792211–21
  48. Thosani N, Abu Dayyeh BK, Sharma P. 48.  et al. 2016. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance. Gastrointest. Endosc. 834684–98.e7
  49. Mannath J, Subramanian V, Hawkey CJ. 49.  et al. 2010. Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett's esophagus: a meta-analysis. Endoscopy 425351–59
  50. Overholt BF, Wang KK, Burdick JS. 50.  et al. 2007. Five-year efficacy and safety of photodynamic therapy with photofrin in Barrett's high-grade dysplasia. Gastrointest. Endosc. 663460–68
  51. Shaheen NJ, Greenwald BD, Peery AF. 51.  et al. 2010. Safety and efficacy of endoscopic spray cryotherapy for Barrett's esophagus with high-grade dysplasia. Gastrointest. Endosc. 714680–85
  52. Gosain S, Mercer K, Twaddell WS. 52.  et al. 2013. Liquid nitrogen spray cryotherapy in Barrett's esophagus with high-grade dysplasia: long-term results. Gastrointest. Endosc. 782260–65
  53. Canto MI, Shin EJ, Khashab MA. 53.  et al. 2015. Safety and efficacy of carbon dioxide cryotherapy for treatment of neoplastic Barrett's esophagus. Endoscopy 477582–91
  54. Shaheen NJ, Sharma P, Overholt BF. 54.  et al. 2009. Radiofrequency ablation in Barrett's esophagus with dysplasia. N. Engl. J. Med. 360222277–88
  55. Orman ES, Li N, Shaheen NJ. 55.  2013. Efficacy and durability of radiofrequency ablation for Barrett's esophagus: systematic review and meta-analysis. Clin. Gastroenterol. Hepatol. 11101245–55
  56. Gupta M, Iyer PG, Lutzke L. 56.  et al. 2013. Recurrence of esophageal intestinal metaplasia after endoscopic mucosal resection and radiofrequency ablation of Barrett's esophagus: results from a US multicenter consortium. Gastroenterology 145179–86.e1
  57. Pouw RE, van Vilsteren FGI, Peters FP. 57.  et al. 2011. Randomized trial on endoscopic resection—cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia. Gastrointest. Endosc. 74135–43
  58. Pech O, May A, Manner H. 58.  et al. 2014. Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology 1463652–60.e1
  59. Terheggen G, Horn EM, Vieth M. 59.  et al. 2016. A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett's neoplasia. Gut. In press
  60. Cunningham D, Allum WH, Stenning SP. 60.  et al. 2006. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N. Engl. J. Med. 355111–20
  61. van Hagen P, Hulshof MCCM, van Lanschot JJB. 61.  et al. 2012. Preoperative chemoradiotherapy for esophageal or junctional cancer. N. Engl. J. Med. 366222074–84
  62. Little AG, Lerut AE, Harpole DH. 62.  et al. 2014. The Society of Thoracic Surgeons practice guidelines on the role of multimodality treatment for cancer of the esophagus and gastroesophageal junction. Ann. Thorac. Surg. 9851880–85
  63. Birkmeyer JD, Siewers AE, Finlayson EVA. 63.  et al. 2002. Hospital volume and surgical mortality in the United States. N. Engl. J. Med. 346151128–37
  64. Chang L, Stefanidis D, Richardson WS. 64.  et al. 2009. The role of staging laparoscopy for intraabdominal cancers: an evidence-based review. Surg. Endosc. 232231–41
  65. Hulscher JBF, van Sandick JW, de Boer AGEM. 65.  et al. 2002. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N. Engl. J. Med. 347211662–69
  66. Luketich JD, Pennathur A, Awais O. 66.  et al. 2012. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann. Surg. 256195–103
  67. Ruurda JP, van der Sluis PC, van der Horst S. 67.  et al. 2015. Robot-assisted minimally invasive esophagectomy for esophageal cancer: a systematic review. J. Surg. Oncol. 1123257–65
  68. Allaix ME, Herbella FA, Patti MG. 68.  2013. Hybrid trans-thoracic esophagectomy with side-to-side stapled intra-thoracic esophagogastric anastomosis for esophageal cancer. J. Gastrointest. Surg. 17111972–79
  69. Biere SSAY, van Berge Henegouwen MI, Maas KW. 69.  et al. 2012. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 37998291887–92
  70. Sgourakis G, Gockel I, Radtke A. 70.  et al. 2010. Minimally invasive versus open esophagectomy: meta-analysis of outcomes. Dig. Dis. Sci. 55113031–40
  71. Darling GE, Altorki NK, Luketich JD. 71.  et al. 2013. Inaugural discussions in cardiothoracic treatment and care: surgery for esophageal cancer, November 16, 2012, Boston, MA. Semin. Thorac. Cardiovasc. Surg. 25138–55
  72. Fuchs HF, Broderick RC, Harnsberger CR. 72.  et al. 2016. Intraoperative endoscopic Botox injection during total esophagectomy prevents the need for pyloromyotomy or dilatation. J. Laparoendosc. Adv. Surg. Tech. A 26:6433–38 [Google Scholar]
  73. Wright CD, Kucharczuk JC, O'Brien SM. 73.  et al. 2009. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons general thoracic surgery database risk adjustment model. J. Thorac. Cardiovasc. Surg. 1373587–95
  74. Bailey SH, Bull DA, Harpole DH. 74.  et al. 2003. Outcomes after esophagectomy: a ten-year prospective cohort. Ann. Thorac. Surg. 751217–22
  75. Omloo JMT, Lagarde SM, Hulscher JBF. 75.  et al. 2007. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann. Surg. 2466992–1000
/content/journals/10.1146/annurev-med-050715-104218
Loading
Esophageal Adenocarcinoma: Screening, Surveillance, and Management
Annual Review of Medicine 68, 213 (2017); https://doi.org/10.1146/annurev-med-050715-104218
/content/journals/10.1146/annurev-med-050715-104218
/content/journals/10.1146/annurev-med-050715-104218
Loading

Data & Media loading...

  • Article Type: Review Article

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error