Treatment of Oesophago-Gastric Tumours

K. Leiper; A. I. Morris

doi:10.1055/s-2002-19858

Endoscopy, Table of Contents

Endoscopy 2002; 34(2): 139-145
DOI: 10.1055/s-2002-19858

State of the Art Review

Treatment of Oesophago-Gastric Tumours

K. Leiper^2-1 , A. I. Morris^2-1

¹Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom

Abstract

The incidence of oesophageal adenocarcinoma continues to rise rapidly in the West whereas cancer of the stomach is becoming less common. Most patients present with advanced disease that is not amenable to curative treatment. This review focuses on recent evidence on the endoscopic therapy of oesophago-gastric cancer. Although there are many treatment modalities available, there is a paucity of good quality randomised trial evidence on which to base palliative treatment decisions. Furthermore, although palliation of dysphagia may be improved by expandable metal stents or ablative therapy, there is no evidence that this improves survival and each of these therapies has a high frequency of complications particularly in longterm survivors. Exciting developments have however been reported in the therapy of early stage oesophago-gastric cancer. Endoscopic mucosal resection is particularly promising with high rates of complete removal of early cancer or high grade dysplasia. Long-term follow up of these patients is required because of high rates of metachronous tumour formation and at present there are no randomised trial data comparing endoscopic mucosal resection with conventional surgery.

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Dr. Keith Leiper

Department of Medicine · University of Liverpool

Daulby Street · Liverpool · L69 3GA · United Kingdom

Fax: + 44-151-706-5802

Email: kleiper@liverpool.ac.uk