title: Surgical palliation for Barrett's esophagus cancer.
abstract: Adenocarcinoma arising in the setting of Barrett's esophagus has the fastest increasing incidence of any malignancy in the United States. Advanced esophageal cancer carries an overall poor prognosis with most patients presenting with incurable disease. Over the past several years, new options have been introduced for the purpose of providing palliative therapy to improve quality of life. Stent placement is the most widely used palliative therapy and rapidly relieves dysphagia; however, distal migration continues to be a disadvantage. Laser therapy and brachytherapy are also administered but require repeated treatment sessions. Future options for providing effective therapy for endstage disease include improved stent designs to decrease migration and multimodality methods that combine several options in one treatment session. This article focuses primarily on palliation of unresectable tumors of the esophagus and gastroesophageal junction.
authors.affiliation: Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Kaufmann Building Suite 401, 3471 Fifth Avenue, Pittsburgh, PA, USA. qureshiir@upmc.edu
authors.forename: Irfan
authors.initials: I
authors.lastname: Qureshi
authors.forename: Manisha
authors.initials: M
authors.lastname: Shende
authors.forename: James D
authors.initials: JD
authors.lastname: Luketich
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D001471:Barrett Esophagus / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D001918:Brachytherapy; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D005544:Forecasting; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D015994:Incidence; D053685:Laser Therapy; D010166:Palliative Care / Q000379:methods*; D010778:Photochemotherapy; D011379:Prognosis; D011788:Quality of Life; D015607:Stents; D015996:Survival Rate; D014481:United States / Q000453:epidemiology