Surgical strategies for early esophageal adenocarcinoma

H. J. Stein, M. Feith

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


The need for extensive surgical resection for early-stage esophageal adenocarcinoma has been challenged by the increasing frequency of early detection in patients with Barrett's esophagus undergoing surveillance endoscopy. Limited endoscopic or surgical procedures are promoted as alternatives to radical esophagectomy and lymphadenectomy in such patients. Currently available data show that limited surgical resection of the distal esophagus with regional lymphadenectomy and interposition of an isoperistaltic jejunal segment is a safe and oncologically adequate procedure in this situation and provides good quality of life. This is in contrast to endoscopic ablation or endoscopic mucosal resection, which are associated with high tumour recurrence rates and persistence of premalignant Barrett esophagus. New technologies for accurate prediction of the presence and pattern of lymphatic spread - e.g. sentinel node techniques and artificial neural networks - may allow a further reduction of the invasiveness of surgical resection without compromising cure rates.

Original languageEnglish
Pages (from-to)927-940
Number of pages14
JournalBailliere's Best Practice and Research in Clinical Gastroenterology
Issue number6
StatePublished - Dec 2005
Externally publishedYes


  • Adenocarcinoma of the distal esophagus
  • Barrett's cancer
  • Early cancer
  • Esophageal cancer
  • Esophagectomy
  • Lymph-node metastases
  • Lymphadenectomy
  • Prognosis
  • Prognostic factors
  • Sentinel node
  • Squamous-cell esophageal cancer


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