Esophagus

--Daly JM, Fry WA, Little AG, Winchester DP, McKee RF, Stewart AK, Fremgen AM. Esophageal cancer: Results of an American College of Surgeons Patient Care Evaluation study. JACS 2000; 190:562-572. (!)

--Daly JM, Karnell LH, Menck HR. National Cancer Data Base report on esophageal carcinoma. Cancer 1996; 78:1820-1828. (!)

Using the National Cancer Data Base's most current accrual of data for cases diagnosed in 1988 and 1993, patterns of care and outcome were analyzed for esophageal carcinoma. A substantial increase was demonstrated between 1988 and 1993 in the proportion of esophageal adenocarcinomas and patients presenting with stage IV disease. The therapeutic regiment most frequently employed in 1993 was combined radiation therapy and chemotherapy, which rose 8.2% from 22% in 1988. The dramatic rise across the years of this study in the occurrence of esophageal adenocarcinomas indicates a need for developing strategies to evaluate Barrett's preneoplastic mucosal changes more precisely. The increasing use of combined chemotherapy and radiation therapy reflects the results of randomized trails that have demonstrated improved response and outcome for this combined regimen compared with radiation therapy alone. There was no substantial increase in the use of surgical resection with chemotherapy and radiation therapy throughout these years.

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