Multimodal Therapy for Adenocarcinoma of the Esophagus and Esophagogastric Junction

Abstract
In the Western world the incidence of adenocarcinoma of the esophagus has risen markedly in the past three decades. Barrett's specialized columnar-cell metaplasia (Barrett's esophagus), which is the most important predisposing factor, is found in more than 80 percent of patients with adenocarcinoma of the distal esophagus.1 Although recent studies indicate that microscopic areas of metaplasia may also occur in true carcinoma of the cardia and subcardial carcinoma,2 the etiology, epidemiology, and pathology of these tumors appear to differ from those of adenocarcinoma of the esophagus.3 Adenocarcinoma of the distal esophagus often grows submucosally toward the proximal esophagus and spreads . . .