Treatment of Dysplasia in Barrett Esophagus.
- Author:
Javier ARANDA-HERNANDEZ
1
;
Maria CIROCCO
;
Norman MARCON
Author Information
1. Division of Gastroenterology, Department of Medicine, The Center of Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto Faculty of Medicine, Toronto, ON, Canada. norman.marcon@utoronto.ca
- Publication Type:Review
- Keywords:
Barrett esophagus;
Therapeutics;
Dysplasia;
Endoscopy;
Endoscopic treatment
- MeSH:
Adenocarcinoma;
Barrett Esophagus*;
Catheter Ablation;
Endoscopy;
Esophagectomy;
Esophagus;
Humans;
Lymph Nodes;
Mass Screening;
Neoplasm Metastasis;
Risk Factors;
Survival Rate
- From:Clinical Endoscopy
2014;47(1):55-64
- CountryRepublic of Korea
- Language:English
-
Abstract:
Barrett esophagus is recognized as a risk factor for the development of dysplasia and adenocarcinoma of the esophagus. Cancer is usually diagnosed at an advanced stage with a 5-year survival rate of 15%. Most of these patients present de novo and are not part of a surveillance program. Endoscopic screening with improvement in recognition of early lesions may change this pattern. In the past, patients diagnosed with dysplasia and mucosal cancer were best managed by esophagectomy. Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy. This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis. The role of endoscopic therapy for superficial submucosal disease continues to be a challenge.
