Multimodality treatment of cancer arising from Barrett's epithelium.

Adenocarcinoma arising in Barrett's epithelium is seen with increasing frequency. Most patients are diagnosed with advanced cancer, and the overall survival is less than 15%. Therefore novel preventive and therapeutic strategies are needed. Molecular markers are being developed that may predict which patients with Barrett's will develop cancer. Combined modality therapy with chemotherapy and surgery has been studied extensively in clinical trials. Although the results of these studies suggest improved survival, definitive proof must await completion of ongoing randomized trials. Surgical resection of adenocarcinoma provides restoration of swallowing and local tumor control with a low operative mortality.