KMID : 0359020090380020068
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Korean Journal of Gastrointestinal Endoscopy 2009 Volume.38 No. 2 p.68 ~ p.74
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The Clinical Characteristics and Outcomes of Barrett¡¯s Cancer at a Single Institution in Korea
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Kim Sang-Jung
Lee Jun-Haeng Kim Bum-Jin Rhee Poong-Lyul Kim Jae-Jun Rhee Jong-Chul Kim Kyoung-Mee Shim Young-Mog
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Abstract
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Background/Aims: The prevalence of Barrett¡¯s esophagus might also be changing along with changes in the epidemiology of GERD, and the incidence of Barrett¡¯s cancer is expected to increase even more. The aim of this study is to evaluate the clinicopathologic features and outcome of the patients with Barrett¡¯s cancer and who were seen at a single institution over a period of 13 years.
Methods: The records of 39 patients with the esophageal adenocarcinoma and who were treated at Samsung Medical Center from January 1995 to August 2008 were reviewed. Among them, 11 patients (28%) with histologically-confirmed Barrett¡¯s cancer were included in the study. The clinicopathological features, endoscopic manifestations and treatment outcome were evaluated.
Results: The male to female ratio was 10£º1. The mean age was 64 years. Most of the patients were diagnosed with Barrett¡¯s cancer after 2000, and there were three such patients (27.3%) in 2008. The frequent chief complaints were epigastric pain (27.3%) and chronic acid reflux symptom (18.2%). Three patients (27.3%) were detected incidentally during screening endoscopy. The macroscopic types based on the endoscopic findings were as follows: 4 lesions with a type IIa appearance (36.4%) and 2 with a type IIb appearance (18.2%). The mean tumor size was 1.2cm at the longest dimension and 0.8 cm at the shortest dimension. Tumor was located in the mucosal layer in six cases (54.5%) and the 5 cases (45.5%) showed submucosal invasion. Lymph node metastasis was found in one case (9.1%). All the cases underwent surgery, except one case for which the tumor was removed by endoscopic submucosal dissection. There was no recurrence during the follow up period.
Conclusions: As the incidence of Barrett¡¯s cancer is increasing, a standard surveillance program that includes the endoscopic biopsy method, the grading system for the dysplasia and the treatment modality should be established.
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KEYWORD
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Barrett¡¯s esophagus, Adenocarcinoma
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