By Simone Giacopuzzi, Andrea Zanoni, Giovanni de Manzoni
This e-book bargains up to date and entire insurance of the analysis and remedy of adenocarcinoma of the esophagogastric junction (EGJ). As is suitable within the period of multidisciplinary and multimodal remedy, the contributions of all of the numerous experts concerned cooperatively within the therapy of EGJ melanoma are completely defined. distinctive consciousness is usually paid to the importance of preneoplastic lesions, akin to Barrett esophagus. the ultimate a part of the e-book represents a surgical atlas documenting the concepts utilized in the EGJ quarter, with remarkable colour pictures and stepwise description of strategies. opposed to the history of the quickly expanding prevalence in EGJ melanoma, in particular obvious in Western international locations, there's a desire for better uniformity in administration concepts, which at present differ considerably the world over. This booklet offers acceptable advice that would support all practitioners all for the prognosis 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
If resistant to one modality, switching to a different mucosal ablation technique should be considered. Postablation Surveillance There are two issues which need to be taken into consideration after successful eradication of Barrett’s which make postablation surveillance mandatory: first is the subsquamous intestinal metaplasia (SSIM or buried Barrett’s), and second is the postablation recurrences after successful eradication of Barrett’s. 10 Subsquamous Intestinal Metaplasia (SSIM) SSIM or “buried Barrett’s” is the presence of intestinal metaplasia in the lamina propria beneath overlying squamous mucosa.
Currently, there is no consensus on After EMR of visible lesions, residual Barrett’s the frequency of surveillance or biopsy protocol needs to be ablated in view of high risk of metain postablation patients. As per recently pub- chronous neoplasia. 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.
Anders M, Lucks Y, El-Masry MA et al (2014) Subsquamous extension of intestinal metaplasia is detected in 98% of cases of neoplastic Barrett’s esophagus [published online July 23, 2013]. Clin Gastroenterol Hepatol 12(3):405–410. doi:http://dx. 013 28. Chennat J, Ross AS, Konda VJ et al (2009) Advanced pathology under squamous epithelium on initial EMR specimens in patients with Barrett’s esophagus and high-grade dysplasia or intramucosal carcinoma: implications for surveillance and endotherapy management.