Adenocarcinoma of the esophagus and cardia: a review of the disease and its treatment.
BACKGROUND
Over the past 50 years there has been a remarkable change in the epidemiology of esophageal cancer. Previously rare, adenocarcinoma of the esophagus and gastroesophageal junction is now the most common esophageal cancer, and in the United States the incidence is increasing faster than that of any other malignancy. Surveillance in patients with Barrett's esophagus is identifying adenocarcinoma at an earlier, more curable stage in many patients, and at the same time new endoscopic and surgical options are available for the therapy of these localized tumors.


METHODS
This article is a review of the epidemiology, diagnosis, staging, and treatment options for esophageal and gastroesophageal junction adenocarcinoma.


RESULTS
The epidemiology, prognosis, patterns of lymphatic metastasis, and survival for esophageal and gastroesophageal junction adenocarcinoma suggest that these tumors are similar. New options for therapy, as well as the results of surgical resection with and without chemoradiotherapy, are reviewed.


CONCLUSIONS
Surveillance programs for Barrett's are identifying patients with early, curable adenocarcinoma of the esophagus or gastroesophageal junction. Therapy for more advanced tumors hinges on local control of the disease and the eradication of systemic metastases.
DeMeester
Steven R
SR
Department of Cardiothoracic Surgery, The University of Southern California, Keck School of Medicine, 1510 San Pablo Street, Suite 514, Los Angeles, California, 90033, USA. sdemeester@surgery.usc.edu
D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D001471:Barrett Esophagus / Q000473:pathology; D002299:Cardia; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D004943:Esophagogastric Junction; D006801:Humans; D015994:Incidence; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010166:Palliative Care; D011788:Quality of Life; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D014481:United States / Q000453:epidemiology