Jaffer A. Ajani, MD | Authors


The Emerging Epidemic of Gastroesophageal Cancers: A Neglected Volcano?

April 30, 2007

Esophageal, gastroesophageal junction, and gastric cancers are underpublicized but are frequently lethal, and gastroesophageal junction adenocarcinomas are increasingly common diseases in the United States and around the world. Although often grouped together in studies of chemotherapy, clear distinctions can be made in the locoregional therapy of these diseases. Esophageal squamous cell carcinomas may be treated with surgery or radiation with concurrent chemotherapy, whereas esophageal adenocarcinomas and gastroesophageal junction adenocarcinomas are often treated with all three treatment modalities. Over the past several years, it has become increasingly evident that gastric cancer is a disease that is potentially sensitive to chemotherapy. In the perioperative setting—at least in the Western world—chemotherapy and sometimes radiation are applied. However, the optimal chemotherapy for advanced gastric or esophageal cancer remains unsettled, and there is no single standard regimen. Several new chemotherapy agents have demonstrated activity in these diseases, but the best chemotherapy remains to be determined. This paper will review the role of chemotherapy in gastroesophageal cancers.

Gastric Carcinoma

April 01, 2005

Despite an overall rise in the incidence of gastrointestinal malignancies in the United States, there has been a significant decrease in the incidence of adenocarcinoma of the stomach over the past few decades. Nevertheless, gastric carcinoma remains the eighth leading cause of cancer death in the United States [1].

Carcinoma of the Esophagus

April 01, 2005

Carcinoma of the esophagus or the gastroesophageal junction is uncommon, accounting for approximately 1% of all malignancies in the United States [1]. An estimated 12,100 new cases and 10,900 deaths will occur in 1995.

Neuroendocrine Tumors of the Gastrointestinal Tract

April 01, 2005

Neuroendocrine tumors manifest in the gastrointestinal tract mainly as carcinoid and pancreatic islet-cell tumors. They comprise an interesting group of rare neoplasms that are derived from neuroendocrine cells interspersed within the gastrointestinal system amd throughout the body. Neuroendocrine tumors are well known for producing various hormonal syndromes and for their indolent clinical course in most patients, although some of these tumors do not produce hormones of clinical significance. Patients may have symptoms for many years before the diagnosis is suspected and confirmed.