The Difficulty of Detecting Esophageal Cancer Preoperatively

Esophagectomy revealed a substantial number of cancers that even the rigorous Seattle biopsy protocol had missed.

Among patients with Barrett esophagus and high-grade dysplasia (HGD) who undergo esophagectomy, the reported prevalence of previously unsuspected esophageal adenocarcinoma ranges from 0% to 73%. This wide variance might be attributable to inadequate tissue sampling because of the lack of a standardized preoperative biopsy protocol.

To validate the rigorous Seattle biopsy protocol — which entails four-quadrant biopsies at 1-cm intervals using jumbo forceps plus sampling of all mucosal abnormalities — investigators retrospectively reviewed the records of 33 patients with BE and HGD (without preoperatively known cancer) who underwent esophagectomy from 1999 through 2006. The Seattle biopsy protocol had been used preoperatively in 20 patients; a…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors