Die beste therapeutische Option in der Therapie des Barrett-Adenokarzinoms besteht in der Entfernung des Primärtumors und seiner regionalen Lymphknotenmetastasen, sofern eine komplette Resektion ohne Residualtumor erreicht werden kann. Das Operationsverfahren der Wahl ab einer Tumorinfiltration der Submukosa ist die subtotale Enbloc-Ösophagektomie mit 2-Feld-Lymphadenektomie und hoch intrathorakaler Ösophagogastrostomie. Das Barrett-Adenokarzinom wird jedoch überwiegend erst in einem lokal fortgeschrittenen oder metastasierten Stadium diagnostiziert. Deshalb wurden in den letzten Jahren neoadjuvante Therapiekonzepte etabliert, um die R0-Resektionsrate zu steigern und systemische Mikrometastasen zu eliminieren.

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