Esophageal Cancer and Barrett's Esophagus

PROFESSOR PRATEEK SHARMA, Professor Medicine, University of Kansas School of Medicine and Veterans Affairs Medical Center, Kansas City, Missouri, and Southern Arizona Veterans Affairs Health Care System and Arizona Health Sciences Center, Tucson, Arizona, USA. PROFESSOR RICHARD SAMPLINER, Professor of Medicine at the University of Arizona, Tucson, AZ, USA, and Chief of Gastroenterology at the Southern Arizona VA Health Care System. DAVID ILSON, MD, PHD, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

• List of contributors ixPreface xiii1 Epidemiology of esophageal carcinoma 1Mohammad H. Shakhatreh and Hashem B El-Serag1.1 The incidence and mortality related to esophageal cancer 11.2 Mortality 21.3 Risk factors for EA 22 Barrett's esophagus: definition and diagnosis 15Stuart Jon Spechler2.1 Introduction 152.2 Early history of Barrett's esophagus 152.3 Early reports on the histology of Barrett's esophagus 162.4 Identification of the gastroesophageal junction 162.5 Recognition of short segment Barrett's esophagus 172.6 Intestinal metaplasia and adenocarcinoma of the esophagus 182.7 The problem of cardiac mucosa 182.8 Definition of Barrett's esophagus 192.9 Diagnostic criteria for Barrett's esophagus 192.10 Intestinal metaplasia at the GEJ 203 Epidemiology and prevalence of Barrett's esophagus 25Helen G. Coleman, Shivaram K. Bhat and Liam J. Murray3.1 Introduction 253.2 BE prevalence 253.3 BE incidence 283.4 Etiology and risk factors for BE 303.5 Neoplastic progression risk in BE 303.6 Conclusions 314 Esophageal adenocarcinoma: risk factors 35Mariam Naveed and Kerry B. Dunbar4.1 Introduction 354.2 Gastroesophageal reflux disease (GERD) 354.3 Barrett's esophagus (BE) 364.4 Obesity 374.5 Smoking 374.6 Alcohol 384.7 Dietary factors 384.8 Medication use 384.9 H. pylori 394.10 Demographics 394.11 Summary 395 Esophageal motility abnormalities in Barrett's esophagus 45Kumar Krishnan, John E. Pandolfino and Peter J. Kahrilas5.1 Introduction 455.2 Antireflux barrier 455.3 Lower esophageal sphincter 465.4 Diaphragmatic sphincter and hiatal hernia 465.5 Mechanical properties of the relaxed EGJ 475.6 Esophageal clearance 485.7 Peristaltic dysfunction 495.8 Gastric emptying and duodenogastroesophageal reflux 495.9 Therapy of motor abnormalities in Barrett's esophagus 505.10 Conclusion 506 Molecular biology of Barrett's esophagus and esophageal adenocarcinoma 55Ayesha Noorani and Rebecca C. Fitzgerald6.1 Introduction 556.2 Genetic and host susceptibility 556.3 Environmental factors contributing to the development of BE 576.4 Genomic instability mutations and copy number changes in candidate genes 586.5 The advent of next generation sequencing 616.6 Future directions and conclusions 637 Histology of Barrett's esophagus: metaplasia and dysplasia 69Deepa T. Patil and John R. Goldblum7.1 Introduction 697.2 Normal anatomy and histology 697.3 Histology of Barrett's esophagus 697.4 Intestinal metaplasia of the EGJ 717.5 Barrett's esophagus-related dysplasia 717.6 Intramucosal adenocarcinoma (IMC) 727.7 Submucosal adenocarcinoma 737.8 Morphologic types of dysplasia 737.9 Sampling error and observer variation in Barrett's esophagus-related dysplasia 747.10 Surrogate biomarkers for assessing risk of esophageal adenocarcinoma 748 Helicobacter pylori and esophageal neoplasia 79Arne Kandulski, Marino Venerito and Peter Malfertheiner8.1 Introduction 798.2 H. pylori infection -- gastritis pattern and gastric physiology with impact on gastroesophageal reflux disease 798.3 Epidemiological studies -- GERD symptoms, erosive esophagitis and H. pylori 808.4 H. pylori, Barrett's esophagus and esophageal adenocarcinoma 818.5 H. pylori eradication and GERD 828.6 H. pylori and esophageal squamous cell carcinoma 838.7 Conclusions 849 Screening and surveillance 87Sarmed S. Sami and Krish Ragunath9.1 Introduction 879.2 Screening 879.3 Surveillance 909.4 Conclusion 9310 New surface imaging technologies for dysplasia and cancer detection 97David F. Boerwinkel, Wouter L. Curvers and Jacques J.G.H.M. Bergman10.1 Introduction 9710.2 Surface imaging in Barrett's esophagus 9810.3 Surface imaging for esophageal squamous cell carcinoma 10310.4 Summary 10411 New cellular imaging technologies for dysplasia and cancer detection 107Helmut Neumann and Ralf Kiesslich11.1 Introduction 10711.2 Confocal laser endomicroscopy 10711.3 Endocytoscopy 11011.4 Optical coherence tomography 11111.5 Molecular imaging in Barrett's 11211.6 Conclusion 11212 The role of endoscopic ultrasound in esophageal cancer 115Samad Soudagar and Neil Gupta12.1 Background 11512.2 Equipment 11512.3 Visualized EUS anatomy 11512.4 Obstacles to accurate EUS staging 11612.5 Esophageal cancer staging and impact on treatment intervention 11712.6 T staging 11712.7 N staging 11912.8 M staging 12012.9 Restaging after chemoradiotherapy and surveillance for disease recurrence 12012.10 Conclusion/summary 12113 Staging of esophageal adenocarcinoma by CT, PET, and other modalities 125Florian Lordick, Katja Ott, Matthias Ebert, Lars Grenacher, Bernd-Joachim Krause and Christian Wittekind13.1 Introduction 12513.2 Endoscopic staging 12513.3 Staging by external ultrasonography 12813.4 Staging by radiological examinations 12813.5 Staging by positron emission tomography (PET) 12913.6 The value of FDG-PET to predict response to pre-operative treatment 13013.7 Conclusion: summary of recommended staging procedures 13214 Medical management of Barrett's esophagus 137Sachin Wani14.1 Introduction 13714.2 Assessment of symptoms 13714.3 Acid suppressive therapies in management of reflux symptoms 13814.4 Normalization of intraesophageal acid exposure 13814.5 Management of erosive esophagitis 13914.6 Maintenance of healed mucosa after endoscopic eradication therapies 13914.7 Conclusions 14015 Thermal therapies and photodynamic therapy for early esophageal neoplasia 143Jacques Deviere15.1 Introduction 14315.2 Photodynamic therapy 14415.3 Argon plasma coagulation 14415.4 Cryotherapy 14715.5 Conclusion 14716 RFA for early esophageal neoplasia 151Daniel K. Chan, Cadman L. Leggett and Kenneth K. Wang16.1 Background 15116.2 Device and procedural technique 15116.3 Efficacy and durability of radiofrequency ablation 15416.4 Initial treatment response to RFA and risk factors for failed ablation 15616.5 Endoscopic mucosal resection in combination with radiofrequency ablation 15716.6 Safety and tolerability of radiofrequency ablation 15716.7 Subsquamous intestinal metaplasia after radiofrequency ablation 15716.8 Surveillance following radiofrequency ablation 15816.9 Conclusions 15817 The role of endoscopic cryotherapy for treatment and palliation 161Kristle Lee Lynch, Eun Ji Shin and Marcia Irene Canto17.1 Introduction 16117.2 Cryotherapy mechanisms of tissue injury 16117.3 Types of cryotherapy: devices, dosing, and endoscopic application 16217.4 Efficacy and safety in Barrett's esophagus 16417.5 Cryotherapy for the treatment of esophageal carcinoma 16617.6 Summary and future directions 16718 Endoscopic resection 169Oliver Pech18.1 Introduction 16918.2 ER techniques 16918.3 ER in HGIN and early Barrett's cancer 17118.4 ER of submucosal Barrett's adenocarcinoma 17418.5 Conclusions 17419 Endoscopic submucosal dissection 177Hironori Yamamoto, Tsuneo Oyama and Takuji Gotoda19.1 Introduction 17719.2 Indications of ESD for esophageal cancer 17719.3 Preoperative examination 17819.4 Techniques of ESD [19--22] for esophageal cancer 17819.5 Complications 18419.6 Sedation and anesthesia 18519.7 Results 18519.8 Training 18519.9 Conclusion 18620 Surgical therapy of early esophageal cancer 189Toshitaka Hoppo and Blair A. Jobe20.1 Introduction 18920.2 "Early" esophageal cancer 18920.3 Indication of surgical resection for early esophageal adenocarcinoma 19020.4 Strategy of surgical resection for early esophageal adenocarcinoma 19020.5 Choice of surgical approach and outcomes 19120.6 Discussion 19420.7 Conclusion 19521 Chemoprevention: can we prevent esophageal cancer? 199Janusz Jankowski and Mary Denholm21.1 Overview 19921.2 The effect of aspirin on cancer prevention 20021.3 Risks and adverse effects of aspirin 20121.4 The role of aspirin in reflux disease 20321.5 Risk-benefits of aspirin 20421.6 AspECT trial 20522 Selection of patients for cancer prevention and eradication 209Aaron J. Small and Gary W. Falk22.1 Introduction 20922.2 Patient factors 20922.3 Cancer risk and grade of dysplasia 21022.4 Baseline quality measures 21222.5 The lesion 21322.6 Predictors of response 21522.7 Predictors of initial response to therapy 21522.8 Future considerations 21722.9 Conclusions 21723 Combined modality therapy in locally advanced esophageal cancer 221Geoffrey Y. Ku and David H. Ilson23.1 Introduction 22123.2 Pre-operative chemotherapy 22123.3 Post-operative therapy 22223.4 Chemoradiation for medically inoperably patients 22423.5 Pre-operative chemoradiation 22423.6 Pre-operative chemoradiation vs. chemotherapy 22523.7 Definitive vs. pre-operative chemoradiation 22523.8 Newer chemoradiation regimens 22623.9 Targeted therapies 22623.10 Positron emission tomography-directed therapy 22723.11 Conclusion 22824 Surgery in locally advanced esophageal cancer 231Nabil Rizk24.1 Introduction 23124.2 Chemotherapy, chemoradiation and surgical complications 23124.3 Technical considerations 23224.4 Risks of salvage surgery 23324.5 Conclusion 23425 Radiation therapy for locally advanced esophageal cancer 237Heath D. Skinner and Bruce D. Minsky25.1 Introduction 23725.2 Definitive therapy in unresectable locally advanced esophageal cancer 23725.3 Trimodality therapy 24025.4 Techniques of radiation therapy 24325.5 Conclusions 24526 Systemic therapy and targeted agents in advanced esophageal cancer 251Mark A. Lewis and Harry H. Yoon26.1 Introduction 25126.2 Chemotherapy 25126.3 Targeted therapy 25326.4 Future directions 25826.5 Conclusions 25927 Role of endoscopy and nutritional support in advanced esophageal cancer 265Manol Jovani, Andrea Anderloni and Alessandro Repici27.1 Introduction 26527.2 Nutritional support in advanced esophageal cancer 26627.3 Palliative endoscopy in inoperable esophageal cancer 26627.4 Conclusion 273Index 277