Barrett's esophagus, Adenocarcinoma"/> The Clinical Characteristics and Outcomes of Barrett's Cancer at a Single Institution in Korea
Korean J Gastrointest Endosc > Volume 38(2); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;38(2): 68-74.
단일 기관에서 경험한 바렛식도암의 임상적 고찰
김상중ㆍ이준행ㆍ김범진ㆍ이풍렬ㆍ김재준ㆍ이종철ㆍ김경미*ㆍ심영목†s
성균관대학교 의과대학 삼성서울병원 내과, *병리과, 흉부외과
The Clinical Characteristics and Outcomes of Barrett's Cancer at a Single Institution in Korea
Sang-Jung Kim, M.D., Jun Haeng Lee, M.D., Beom Jin Kim, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D., Jong Chul Rhee, M.D., Kyoung Mee Kim, M.D.* and Yong Mog Shim, M.D.
Departments of Medicine *Pathology and Thoracic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
Abstract


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 10:1. 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 1.2 cm 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. (Korean J Gastrointest Endosc 2009;38:68-74)

Key Words: Barrett's esophagus, Adenocarcinoma
주요어: 바렛식도, 선암
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