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Aim: The purpose of this study was to assess the role of marital status in esophageal adenocarcinoma (EAC). Methods: We identified 8341 EAC patients based on the Surveillance, Epidemiology and End Results database during 2007–2015, of whom 7275 were male and 1066 were female. Temporal trends, competing risk analysis and propensity score matching were performed. Results: There was an upward trend for the rate of unmarried patients in both male and female populations (p

Introduction Lymph node involvement is the most important predictor of prognosis in oesophageal cancer. The present study describes our single-centre experience of lymphadenopathy in oesophageal carcinoma cases at a tertiary care centre in the Marathwada region of Maharashtra state in western India. Methods This descriptive study included 31 patients who were operated for oesophageal carcinoma at the State Cancer Hospital in Marathwada from August 2015 to September 2017. Thirty patients underwent three-field lymph node dissections, and one patient underwent Ivor Lewis surgery with two-field lymph node dissections. Three-field lymph node dissections were through a thoracotomy, followed by laparotomy and left cervical incision. The lymphatic metastases were categorised as (a) adjacent node metastases, (b) multiple levels of lymph node metastases, and (c) skip node metastases. The histopathological assessment of the removed specimen and lymph nodes was done. Pathologists evaluated the character and depth of the primary tumour and its invasion and node involvement. The location and numbers of positive and negative nodes were recorded. Results A total of 31 patients were included in the study, of which 17 had lymph node involvement. A total of 946 lymph nodes were dissected and examined, and the average number of lymph nodes removed per patient was 30.51. Among the 28 squamous cell carcinoma cases, lymph node involvement was found in 14 cases (50%) whereas, in adenocarcinoma, all the three cases showed lymph node involvement. In 11 cases of squamous cell carcinoma, thoracic lymph nodes were involved, whereas abdominal lymph nodes were involved in nine and cervical lymph nodes in two cases. Thoracic lymph nodes were involved in two cases of adenocarcinoma and abdominal lymph nodes were involved in one case of adenocarcinoma. Conclusions Squamous cell carcinoma was the predominant type, and lymph node metastasis was observed in 50% of these cases. Thoracic lymph nodes were more commonly involved. Tumour staging T2 and T3 had an increasing percentage of lymph nodes involved. Lymph node involvement was more in moderately differentiated and undifferentiated oesophageal cancers.

Background : Sleeve gastrectomy (SG) is currently the most performed bariatric procedure worldwide. Recent evidence has indicated an increased risk of Barrett’s esophagus in the long-term after the SG.Aim : To investigate the prevalence of Barrett’s esophagus at histology, gastroesophageal reflux disease symptoms (GERD), and the use of PPI, in a series of patients issued from different bariatric centers with at least five years of follow-up after the SG.Patients and methods : Five bariatric centers (three in France and two in Italy), who had had adopted the policy of offering a systematic endoscopy in search of Barrett’s esophagus confirmed at histology according to British Society of Gastroenterology guidelines, accepted to participate in the present study. Each investigating center was asked to enter information on at least 10 consecutives patients who had had the systematic endoscopy in their center in a standardized database. Results : Exhaustive information was gathered on 90 consecutive patients from the five bariatric centers. There were 66 women and 24 men with a mean age of 41 (sd+/-11) years, a mean follow-up of 78 (sd +/-15) months and a mean total body weight loss was 33 % (sd+/- 19). The prevalence of Barrett’s esophagus at histology in the whole study population was 18,8 % with no significant difference among centers. Weight loss failure was significantly associated with Barrett’s esophagus (pConclusions : This study confirms that the SG results in a high rate of Barrett’s esophagus in the long-term and suggests the need to provide systematic endoscopy in these patients to rule out this condition.; Introduction : la sleeve gastrectomie (SG) est actuellement la procédure de chirurgie bariatrique la plus pratiquée au monde. Des études récentes ont montré un risque augmenté d’œsophage de Barrett (OB) à distance des SG.But de l’étude : évaluer la prévalence de l’OB ainsi que celle des symptômes de reflux gastro-œsophagien (RGO), des signes endoscopiques d’œsophagite et de l'utilisation des IPP dans une série hétérogène de patients avec un recul d’au moins 5 ans après la SG, de façon multicentriqueentre la France et l'Italie. Nous avons également voulu identifier des facteurs de risque associés à l’OB.Patients et Méthode : cinq centres de chirurgie bariatrique (trois en France et deux en Italie) qui avaient adopté la politique de réaliser des fibroscopies systématiques à la recherche d’OB à distance des SG, ont accepté de participer à l’étude. Chaque centre devait inclure au moins 10 patients qui étaient revus en consultation chirurgicale puis qui avaient une fibroscopie au moins cinq ans après la SG. Chaque investigateur devait remplir une base de données standardisée.Résultats : quatre vingt dix patients ont au final été inclus de manière prospective par les cinq centres. Il y avait 66 femmes et 24 hommes avec un âge moyen de 41 (ds+/‐11) ans et un suivi moyen de 78 (ds+/‐15) mois. La prévalence de l’OB à l’histologie sur l’ensemble de la population était de 18,8 % sans différence significative entre les centres. L’échec de SG était associé de façon significative après analyse multivariée avec la présence d’un OB. Les prévalences des symptômes de RGO, des lésions d’œsophagite et de l’utilisation des IPP sont respectivement passées de 21 %, 10 % et 22 % avant la SG à 76 %, 40 % et 52 % au moment du suivi (pConclusion : cette étude confirme un taux élevé d’OB plus de cinq ans après les SG et suggère qu’une stratégie de surveillance et de prise en charge adaptée pour ces patients doit être élaborée. Ces résultats devront être confirmés à plus grande échelle mais il semble qu’un suivi endoscopique à distance des SG soit justifié.

Resume L’incidence des adenocarcinomes de l’œsophage augmente dans les pays occidentaux pour depasser celle des carcinomes epidermoides. Le pronostic est extremement sombre avec une survie a cinq ans qui ne depasse pas 15 %, tous traitements et tous stades confondus. Au moment du diagnostic, plus des deux tiers des patients ont un cancer non operable du fait de l’extension de la maladie ou des co-morbidites associees. L’inclusion dans certaines etudes de differentes localisations tumorales (œsophage et estomac) et de differents types histologiques (adenocarcinome et carcinome epidermoide) rend difficile l’interpretation des resultats. La chirurgie reste a l’heure actuelle le traitement de reference des petites tumeurs. En revanche, dans les formes localement avancees, elle doit etre precedee d’un traitement neoadjuvant soit par chimiotherapie preoperatoire, soit par radiochimiotherapie preoperatoire. Le choix therapeutique se fait en reunion de concertation pluridisciplinaire d’oncologie digestive en fonction des caracteristiques du patient, de la tumeur et de l’expertise du centre. En cas de contre-indication chirurgicale, une radiochimiotherapie exclusive est recommandee. L’objectif de cette revue est de faire la synthese des differentes strategies therapeutiques utilisees dans les adenocarcinomes de l’œsophage.

Introduction:We have previously shown that in early clinical stage esophageal adenocarcinoma, a positron emission tomography standardized uptake values (PET SUVmax) of

Endoscopic screening of the at-risk population with chronic gastroesophageal reflux disease (GERD) for the presence of intestinal metaplasia or Barrett's esophagus has been suggested as a method to reduce mortality from esophageal adenocarcinoma. There are only limited data regarding the use, effectiveness, and temporal trends of this strategy.All patients aged 68 years and older with a new diagnosis of adenocarcinoma of the esophagus from 1994 to 2002 were identified from a linked tumor registry health claims database. Using claims from 1991 to 2002, the use of endoscopy as well as a diagnosis of GERD or Barrett's esophagus during the time interval from 3 years through 6 months prior to diagnosis were measured. The association of these measures with early-stage cancer (in situ, local) and long-term survival was determined, as well as changes over time.We identified 2,754 patients, including 30.8% at early stage. Previous endoscopy had been performed in 11.5% of patients, and GERD and Barrett's esophagus diagnoses were recorded in 22.4 and 8.1% of patients, respectively. Barrett's esophagus diagnosis was strongly associated with both early-stage cancer (odds ratio 3.68, confidence interval (CI) 1.30-10.40) and survival (hazard ratio 0.45, CI 0.25-0.80). A GERD diagnosis was associated only with early stage, and endoscopy was associated only with survival. There was no association of year of diagnosis with stage or survival.Although only a minority of at-risk patients were identified, the findings are consistent with the beneficial effects of recognition. Despite the development of practice guidelines, we were unable to demonstrate any temporal increases in diagnostic frequency or endoscopic utilization, which highlights the challenges that clinicians face.

L’œsophage de Barrett est une complication du reflux gastro-œsophagien qui se caracterise par une metaplasie intestinale de l’œsophage distal. Dans un certain pourcentage de cas, la persistance de l’irritation est responsable du developpement d’une dysplasie epitheliale qui peut progresser par la suite vers un adenocarcinome intramuqueux, puis invasif et finalement metastatique. Sur la base essentiellement de la morphologie, l’anatomopathologiste essaie de predire a partir des biopsies, quels patients sont susceptibles de progresser vers le cancer. Pour l’instant, ce risque est essentiellement base sur le degre de dysplasie epitheliale. Cependant, sa classification est sujette a une mauvaise reproductibilite et sa valeur predictive dans la progression du cancer est limitee. Dans ce contexte, les nouvelles approches de diagnostic moleculaire, notamment: a) la detection de dommages a l’ADN, b) le controle du cycle cellulaire et c) l’instabilite genomique sont tres prometteuses et sont brievement discutees dans cette revue. L’arrivee imminente de la typisation moleculaire devrait permettre de mieux comprendre, diagnostiquer et predire l’evolution de cette maladie.

The incidence rates of oesophageal cancer vary more than those of any other cancer, world-wide. The aim of this study was to examine the epidemiological features of oesophageal cancer in the Nordic countries.Epidemiological data from the Nordic Cancer Registry (NORDCAN Database, http://www.ancr.nu/nordcan.asp) were used for the study analysis.From 1971 to 2000 in the Nordic countries, 18,034 oesophageal cancers were detected in males and 8216 in females. In males, the incidence rates (world age standardized incidence per 100,000) of oesophageal cancer in 1971-75 and 1996-2000 were 2.7 and 6.0 in Denmark, 4.2 and 3.2 in Finland, 3.4 and 5.6 in Iceland, 2.6 and 3.3 in Norway, and 2.9 and 3.3 in Sweden, respectively. In females, the corresponding figures were: Denmark 1.1 and 1.8, Finland 3.1 and 1.3, Iceland 2.5 and 1.3, Norway 0.7 and 0.9, and Sweden 1.1 and 1.0. Each Nordic country showed a significant geographical variation in the incidence of oesophageal cancer. In both males and females the incidence curves began rising after 40 years of age, but significantly more steeply in males than in females. Over the study period, oesophageal cancer mortality increased from 2.97 to 3.68 per 100,000 in males but decreased from 1.30 to 1.08 in females. The incidence rates of oesophageal adenocarcinoma increased in males in all Nordic countries, and the increase was most marked in Denmark. The incidence of oesophageal adenocarcinoma also increased among Danish females, but compared with males, the incidence rate remained significantly lower.The time trends in incidence of oesophageal cancer differ between the Nordic countries, and there has also been geographical variation within them. On a global comparison, the incidence rates of oesophageal cancer are low in the Nordic region. Oesophageal cancer is a male-predominant disease in all Nordic countries, and the incidence rates of oesophageal adenocarcinoma have increased in males and Danish females.

There are two main forms of esophagus cancer with different malignant behaviors: epidermal or squamous carcinoma (ESCC) and esophagus adenocarcinoma (EA). ESCC is associated with ethanol and tobacco consumption (tobacco-specific-Nnitroso compounds). ESCC is among the more aggressive cancers known. The high mortality rate associated with this type of cancer is directly related to a late diagnosis. Thus there is an important challenge to identify biomarkers for early diagnosis (Shimada et al., 2003; Sobin & Fleming, 1997).

Ha sido interesante el entendimiento de la fisiopatología del esófago de Barrett en los últimos 50 años y su asociación como el factor de riesgo más reconocido para adenocarcinoma de esófago, cuya incidencia se incrementa en una tasa mayor que cualquier otro tipo de cáncer, entre un 4-10% anualmente. Este estudio de cohorte retrospectivo pretende determinar la incidencia de adenocarcinoma de esófago en pacientes con esófago de Barrett y esofagitis durante once años de seguimiento, en la Fundación Santa Fe de Bogotá. Contó con 49 pacientes tanto para el grupo de expuestos (esófago de Barrett) como de no expuestos (Esofagitis). La incidencia dentro del grupo de expuestos fue de 4% (2 casos). Los intervalos de confianza del 95% para un riesgo de 4% en los sujetos expuestos, incluyeron el 0 por tanto, no hubo diferencia con la cohorte no expuesta, donde no hubo casos. Ambos eventos se detectaron en endoscopias rutinarias, con intervalo promedio entre el diagnóstico de esófago de Barrett y desarrollo de adenocarcinoma de 7,5 años. No hubo mortalidad en ambos casos. Este puede ser el primer y único estudio de cohortes que evalúa la asociación de esófago de Barrett y adenocarcinoma de esófago que se haya realizado en el país, con seguimiento a 11 años. Los hallazgos en general coinciden con lo referido en la literatura científica disponible. El seguimiento de los pacientes continúa y estos resultados deben considerarse como un informe de avance. It has been interesting the understanding of the Barrett’s Esophagus physiopathology in last 50 years and their association like the more grateful risk factor for Esophagus Adenocarcinoma, whose incidence is increased in a bigger rate that any other cancer type, among 4-10% annually. This retrospective cohort study, seeks to determine Esophagus Adenocarcinoma incidence in Barrett’s Esophagus and Esophagitis patient in eleven years of pursuit, at La Fundación Santa Fe de Bogotá. There were 49 patients for exposed cohort (Barrett Esophagus) as of not exposed (Esophagitis). The exposed cohort incidence was 4% (2 cases). The confidence intervals (CI) of 95% for a 4% risk in the exposed cohort, included 0, therefore; there was not difference with non exposed cohort, where there were not cases. Both events were detected in routinely endoscopic assay, with average interval between Barrett esophagus diagnosis and adenocarcinoma development 7, 5 year-old. There was not mortality in both cases. This could be the first and only retrospective cohort study that evaluates Barrett Esophagus and Esophagus Adenocarcinoma association that has been carried out in the country, with 11 years to pursuit. The discoveries in general coincide with that referred in the scientific available literature. The pursuit of the patients continues and these results should be considered as an advance report.

To evaluate the diagnostic accuracy of esophageal and cardia adenocarcinoma in the Swedish Cancer Register.Based on cancer registers, a rising incidence of esophageal and cardia adenocarcinoma has been reported in several populations, but possible influence of differences in tumor classification has not been evaluated.In a nationwide study in 1995 through 1997, all Swedish patients, born in Sweden and younger than 80 years with esophageal or cardia adenocarcinoma and half of all patients with esophageal squamous cell carcinoma, were prospectively, uniformly, and thoroughly classified. This study classification was compared with the tumor classification in the Swedish Cancer Register, which is based on routine clinical practice.The overall completeness of the Cancer Register was high (98.3%), whereas the site-specific completeness of the Register was 63% for esophageal adenocarcinoma, 74% for cardia adenocarcinoma, and 91% for esophageal squamous cell carcinoma. The incidence of esophageal adenocarcinomas was 16% higher in the study classification compared with that of the Register during the study period, whereas the incidence of cardia adenocarcinoma was 2% lower in the study classification.There is a diagnostic mismatch between esophageal and cardia adenocarcinoma in the clinical setting and, therefore, also in Cancer Registers. In etiologic and therapeutic research, this problem needs consideration, since these tumors have distinct risk factor profiles and could be subjected to different treatment strategies. The increasing incidence rate of esophageal adenocarcinoma in Sweden is unlikely to be explained by such differences in tumor classification, however.

l'adenocarcinome de l'oesophage est en augmentation. Il est la consequence de la degenerescence d'un endo-brachy-œsophage (EBO), lui-meme consequence d'un reflux gastro-œsophagien. Seuls, la detection lors de la surveillance de l'EBO, et le traitement de lesions au stade de dysplasie de haut grade ou de carcinome localise non invasif, peuvent ameliorer le pronostic de cette forme de cancer œsophagien. Les modalites de surveillance sont desormais codifiees. La chromoendoscopie apparait une aide appreciable pour detecter des lesions a un stade precoce. Phototherapie dynamique et mucosectomie endoscopique sont, a ce stade, des alternatives a la chirurgie. La radiofrequence semble egalement une alternative interessante.