By Simone Giacopuzzi, Andrea Zanoni, Giovanni de Manzoni
This booklet bargains updated and complete insurance of the analysis and remedy of adenocarcinoma of the esophagogastric junction (EGJ). As is acceptable within the period of multidisciplinary and multimodal remedy, the contributions of the entire quite a few experts concerned cooperatively within the remedy of EGJ melanoma are completely defined. distinct consciousness is usually paid to the importance of preneoplastic lesions, comparable to Barrett esophagus. the ultimate a part of the ebook represents a surgical atlas documenting the concepts utilized in the EGJ zone, with tremendous colour pictures and stepwise description of strategies. opposed to the historical past of the quickly expanding occurrence in EGJ melanoma, in particular glaring in Western international locations, there's a desire for higher uniformity in administration innovations, which at the moment fluctuate considerably internationally. This booklet offers applicable counsel that may help all practitioners concerned about the analysis and remedy of EGJ cancers, together with surgeons, oncologists, and radiotherapists.
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Extra resources for Adenocarcinoma of the Esophagogastric Junction: From Barrett's Esophagus to Cancer
2 Efficacy RFA is highly efficacious in eradication of metaplasia (71–93 %) and dysplasia (91–100 %). The most compelling evidence for the use of RFA 4 Ablation Techniques for Barrett’s Esophagus and Dysplasia a Generator b Catheters 27 Barrx 360 Barrx 90 Barrx 60 Barrx 90 Ultra Channel Catheter Before Ablation c After Ablation d Fig. 1 Radiofrequency ablation equipment. (a) Generator. (b) Catheters. (c) Before ablation. N. Thota 28 in BE with dysplasia comes from AIM dysplasia trial , a US multicenter randomized sham- controlled trial of 127 patients.
In addition, there have been recent case series describing the use of endoscopic therapy in early submucosal cancers. 2 Ablative Techniques The various available ablative therapies include radiofrequency ablation (RFA), photodynamic therapy (PDT), cryotherapy, argon plasma coagulation (APC), and multipolar electrocoagulation (MPEC). What are the criteria of an ideal ablation technique in Barrett’s esophagus? As described by Bergman et al. , firstly it should remove all dysplasia and intestinal metaplasia.
In the absence of visible lished British guidelines , in patients treated lesions, ablative therapy is the treatment of for HGD, endoscopic follow-up is recommended choice. In view of risk of recurrence, patients every 3 months for 1 year and yearly thereafter. need to be on ongoing surveillance with treatThis should include biopsies at the cardia and ment of recurrences endoscopically. Due to the lack of head-to-head randomized within the previous extent of the Barrett’s epithelium. For patients with LGD, annual surveillance controlled trials comparing different ablative therapies, no one ablation modality suits all is recommended.