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A random Abstract
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Endoscopic assessment and management of early esophageal adenocarcinoma.
[esophageal carcinoma]
Esophageal
carcinoma
affects
more
than
450000
people
worldwide
and
the
incidence
is
rapidly
increasing
.
In
the
United
States
and
Europe
,
esophageal
adenocarcinoma
has
superseded
esophageal
squamous
cell
carcinoma
in
its
incidence
.
Esophageal
cancer
has
a
high
mortality
rates
secondary
to
the
late
presentation
of
most
patients
at
advanced
stages
.
Endoscopic
screening
is
recommended
for
patients
with
multiple
risk
factors
for
cancer
in
Barrett
's
esophagus
.
These
risk
factors
include
chronic
gastroesophageal
reflux
disease
,
hiatal
hernia
,
advanced
age
,
male
sex
,
white
race
,
cigarette
smoking
,
and
obesity
.
The
annual
risk
of
esophageal
cancer
is
approximately
0
.
25
%
for
patients
without
dysplasia
and
6
%
for
patients
with
high
-grade
dysplasia
.
Twenty
percent
of
all
esophageal
adenocarcinoma
in
the
United
States
is
early
stage
with
disease
confined
to
the
mucosa
or
submucosa
.
The
significant
morbidity
and
mortality
of
esophagectomy
make
endoscopic
treatment
an
attractive
option
.
The
American
Gastroenterological
Association
recommends
endoscopic
eradication
therapy
for
patients
with
high
-grade
dysplasia
.
Endoscopic
modalities
for
treatment
of
early
esophageal
adenocarcinoma
include
endoscopic
resection
techniques
and
endoscopic
ablative
techniques
such
as
radiofrequency
ablation
,
photodynamic
therapy
and
cryoablation
.
Endoscopic
therapy
should
be
precluded
to
patients
with
no
evidence
of
lymphovascular
invasion
.
Local
tumor
recurrence
is
low
after
endoscopic
therapy
and
is
predicted
by
poor
differentiation
of
tumor
,
positive
lymph
node
and
submucosal
invasion
.
Surgical
resection
should
be
offered
to
patients
with
deep
submucosal
invasion
.
Diseases
Validation
Diseases presenting
"high-grade dysplasia"
symptom
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
trochlear dysplasia
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