Premium
Changing disease burden and management issues for esophageal cancer in the Asia–Pacific region
Author(s) -
Law Simon,
Wong John
Publication year - 2002
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2002.02728.x
Subject(s) - medicine , esophagus , cancer , esophageal cancer , disease , endoscopic mucosal resection , general surgery , oncology , gastroenterology , surgery , endoscopy
Abstract The changing epidemiology of esophageal cancer in developed countries is from squamous cell type to adenocarcinomas arising from Barrett’s epithelium and the gastric cardia. This has implications for management of this disease. Earlier diagnosis of cancer from screening high‐risk patients with Barrett’s esophagus is potentially possible, and mucosal ablation together with acid‐suppressive therapies have been investigated to revert Barrett’s epithelium in its premalignant stage. When a cancer has developed, the strategies of staging methodology and surgical approaches also differ from those applicable for squamous cell cancers located in more proximal locations of the esophagus. By contrast, in the Asia–Pacific region (with the exceptions of Australia and New Zealand), squamous cell cancers in the middle portion of the esophagus remain the main cell type seen. An overall increase in life expectancy has led to more elderly patients presenting with carcinoma of the esophagus. This is of particular importance when surgical resection is contemplated. Advances in surgical management, multimodality programs, and endoscopic therapies are most marked in recent years. Treatment for patients with esophageal cancer should be individualized. The choice depends on expertise and facilities available, tumor and patient factors , and local economics. © 2002 Blackwell Publishing Asia Pty Ltd