title: The epidemiology, diagnosis, and treatment of Barrett's carcinoma.
abstract: BACKGROUND
  Roughly 3000 new cases of Barrett's carcinoma arise in Germany each year. In view of recent advances in the epidemiology, diagnosis, and treatment of this disease, an update of the clinical recommendations is in order.
  
  
  METHODS
  This review is based on selected relevant publications, including current reviews, meta-analyses, and guidelines.
  
  
  RESULTS
  The risk of progression of Barrett's esophagus to carcinoma lies between 0.10% and 0.15% per year. Risk factors for progression include male sex, age over 50 years, obesity, longstanding and frequent reflux symptoms, smoking, length of the Barrett's esophagus, and intraepithelial neoplasia. Well-differentiated carcinomas that are confined to the esophageal mucosa can be resected endoscopically with a cure rate above 90%. For more advanced, but still locally confined tumors, surgical resection is the treatment of choice. In stages cT3/4, the prognosis can be improved with neo-adjuvant chemo - therapy or combined radiotherapy and chemotherapy. Metastatic Barrett's carcinoma can be treated by endoscopic, chemotherapeutic, radiotherapeutic, and palliative methods.
  
  
  CONCLUSIONS
  Early carcinoma can often be cured by endoscopic resection. Locally advanced carcinoma calls for multimodal treatment. Current research focuses on means of preventing the progression of Barrett's esophagus, the scope of applicability of endoscopic techniques, and the optimization of multimodal treatment strategies for advanced disease.
authors: Department of Internal Medicine and Gastroenterology, Diakonie Klinikum, Jung-Stilling Hospital, Siegen, Department of General Practice, Internal Medicine and Gastroenterology, HELIOS Hospital Berlin-Buch, Institute of Pathology, Ruhr-University Bochum, Dr.-Horst-Schmidt-Kliniken, Wiesbaden, Department of General, Visceral and Cancer Surgery, University of Cologne.
authors: Joachim
authors: J
authors: Labenz
authors: Herbert
authors: H
authors: Koop
authors: Andrea
authors: A
authors: Tannapfel
authors: Ralf
authors: R
authors: Kiesslich
authors: Arnulf H
authors: AH
authors: Hölscher
mesh_terms: D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015984:Causality; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D012307:Risk Factors