Trial Information

AdCa of the Esophagus and Cardia (ADEC): Relationship Between Nodal Metastasization and the Presence Absence of Intestinal Metaplasia in the Esophagus and Stomach

The assumption that adenocarcinoma of the esophagus and cardia (ADEC) originates only from
the sequence intestinal metaplasia followed by dysplasia and cancer is controversial. It has
been shown that biological patterns differ according to the presence (+) absence (-) of
Barrett's epithelium (BIM) and of gastric intestinal metaplasia (GIM) in the fundus and
antrum. Lymphatic metastatic spreading may differ according to the type of tumor.

Preoperatively patients underwent histological search for Barrett's esophagus (BIM) in
mucosa surrounding (ADEC) and intestinal metaplasia in the gastric corpus and antrum mucosa
(GIM). Patients in which BIM was documented underwent sub total esophagectomy and gastric
pull up (group 1), others underwent esophagectomy at the azygos vein + total gastrectomy
with Roux Y esophagojejunostomy (group 2). Radical lymphadenectomy was identical in both
procedures except for the greater curvature station.