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Published in: Journal of Gastrointestinal Surgery 7/2009

01-07-2009 | SSAT Controversy in GI Surgery Debate

Endotherapy for Barrett’s Esophagus with High-Grade Dysplasia and Intramucosal Carcinoma

Author: Drew B. Schembre

Published in: Journal of Gastrointestinal Surgery | Issue 7/2009

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Excerpt

The incidence of adenocarcinoma of the esophagus in the USA appears to be rising rapidly.1,2 The prevalence of Barrett’s esophagus (BE) appears to be increasing as well.3 The vast majority of adenocarcinoma of the esophagus arises within Barrett’s esophagus, and the identification of the immediate histologic precursor to cancer, high-grade dysplasia (HGD), is the endpoint of current Barrett’s surveillance programs.4 Once HGD has been found, management has included close endoscopic surveillance, esophagectomy, and, more recently, endoscopic ablative therapies (ET). ET has included photodynamic therapy (PDT), endoscopic mucosal resection (EMR), endoscopic submucosal dissection, radiofrequency ablation (RFA) and cryotherapy, as well as a variety of thermal treatments such as argon plasma coagulation (APC).59
Literature
2.
5.
go back to reference Overholt BF, Lightdale CJ, Wang KK, Canto MI et al. Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett’s esophagus: International, partially blinded, randomized phase III trial. Gastrointest Endosc 2005;62:488–498. doi:10.1016/j.gie.2005.06.047.PubMedCrossRef Overholt BF, Lightdale CJ, Wang KK, Canto MI et al. Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett’s esophagus: International, partially blinded, randomized phase III trial. Gastrointest Endosc 2005;62:488–498. doi:10.​1016/​j.​gie.​2005.​06.​047.PubMedCrossRef
6.
go back to reference Sharma VK, Fleischer DE, Wang KK et al. A randomized multi-center trial of radiofrequency (RF) ablation of specialized intestinal metaplasia (SIM) of the esophagus using a balloon-based bipolar electrode array: Preliminary results. Gastrointest Endosc 2004;59:113. doi:10.1016/S0016-5107(04)00554-1.CrossRef Sharma VK, Fleischer DE, Wang KK et al. A randomized multi-center trial of radiofrequency (RF) ablation of specialized intestinal metaplasia (SIM) of the esophagus using a balloon-based bipolar electrode array: Preliminary results. Gastrointest Endosc 2004;59:113. doi:10.​1016/​S0016-5107(04)00554-1.CrossRef
14.
go back to reference Lin O, Schembre D, Mergener K et al. Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux. Gastrointest Endosc 2007;65:577–583. doi:10.1016/j.gie.2006.06.035.PubMedCrossRef Lin O, Schembre D, Mergener K et al. Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux. Gastrointest Endosc 2007;65:577–583. doi:10.​1016/​j.​gie.​2006.​06.​035.PubMedCrossRef
16.
go back to reference Liu L, Hofstetter WL, Rashid A et al. Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. Am J Surg Pathol 2005;29:1079–1085.PubMed Liu L, Hofstetter WL, Rashid A et al. Significance of the depth of tumor invasion and lymph node metastasis in superficially invasive (T1) esophageal adenocarcinoma. Am J Surg Pathol 2005;29:1079–1085.PubMed
18.
go back to reference Buskens C, Westerterp M, Lagarde S et al. Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc 2004;60:703–710. doi:10.1016/S0016-5107(04)02017-6.PubMedCrossRef Buskens C, Westerterp M, Lagarde S et al. Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc 2004;60:703–710. doi:10.​1016/​S0016-5107(04)02017-6.PubMedCrossRef
19.
go back to reference Berenson MM, Johnson TD, Markowitz NR et al. Restoration of squamous mucosa after ablation of Barerett’s esophageal epithelium. Gastroenterology 1993;104:1686–1691.PubMed Berenson MM, Johnson TD, Markowitz NR et al. Restoration of squamous mucosa after ablation of Barerett’s esophageal epithelium. Gastroenterology 1993;104:1686–1691.PubMed
21.
go back to reference Schembre D, Ayub K, Jiranek G. Endoscopic mucosal resection changes staging for early-stage neoplasia in Barrett’s esophagus compared to pinch biopsies and EUS. Gastrointest Endosc 2006;63:AB122.CrossRef Schembre D, Ayub K, Jiranek G. Endoscopic mucosal resection changes staging for early-stage neoplasia in Barrett’s esophagus compared to pinch biopsies and EUS. Gastrointest Endosc 2006;63:AB122.CrossRef
25.
go back to reference Buttar NS, Wang KK, Lutzke LS et al. Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett’s esophagus. Gastrointest Endosc 2001;54:682–688.PubMed Buttar NS, Wang KK, Lutzke LS et al. Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett’s esophagus. Gastrointest Endosc 2001;54:682–688.PubMed
26.
go back to reference Pacifico RJ, Wang KK, Wongkeesong LM, Buttar NS, Lutzke LS. Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett’s esophagus. Clin Gastroenterol Hepatol 2003;1:252–257. doi:10.1016/S1542-3565(03)00129-0.PubMedCrossRef Pacifico RJ, Wang KK, Wongkeesong LM, Buttar NS, Lutzke LS. Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett’s esophagus. Clin Gastroenterol Hepatol 2003;1:252–257. doi:10.​1016/​S1542-3565(03)00129-0.PubMedCrossRef
27.
30.
go back to reference Ganz RA, Overholt BF, Sharma VK et al. Circumferential ablation of Barrett’s esophagus that contains high-grade dysplasia: A U.S. multicenter registry. Gastrointest Endosc 2008;68:35–40.PubMedCrossRef Ganz RA, Overholt BF, Sharma VK et al. Circumferential ablation of Barrett’s esophagus that contains high-grade dysplasia: A U.S. multicenter registry. Gastrointest Endosc 2008;68:35–40.PubMedCrossRef
31.
go back to reference Pouw RE, Sondermeijer C, Ten Kate FJ et al. Stepwise circumferential and focal radiofrequency energy ablation of Barrett’s esophagus with early neoplasia: First European multi-centre trial. Gastrointest Endosc 2008;76:AB137. doi:10.1016/j.gie.2008.03.255.CrossRef Pouw RE, Sondermeijer C, Ten Kate FJ et al. Stepwise circumferential and focal radiofrequency energy ablation of Barrett’s esophagus with early neoplasia: First European multi-centre trial. Gastrointest Endosc 2008;76:AB137. doi:10.​1016/​j.​gie.​2008.​03.​255.CrossRef
32.
go back to reference Dumont JA, Vargo JJ, Zuccaro G et al. Results of cryospray ablation for esophageal high grade dysplasia (HGD) and intramucosal cancer (IMCA) in high risk non-surgical patients. Gastrointest Endosc 2008;67:AB176. doi:10.1016/j.gie.2008.03.418.CrossRef Dumont JA, Vargo JJ, Zuccaro G et al. Results of cryospray ablation for esophageal high grade dysplasia (HGD) and intramucosal cancer (IMCA) in high risk non-surgical patients. Gastrointest Endosc 2008;67:AB176. doi:10.​1016/​j.​gie.​2008.​03.​418.CrossRef
37.
go back to reference Schembre D, Arai AD, Levy SM et al. Quality of life after esophagectomy and endoscopic therapy for Barrett’s esophagus with high-grade dysplasia or intra-mucosal carcinoma. Gastrointest Endosc 2008;67:AB251. doi:10.1016/j.gie.2008.03.668.CrossRef Schembre D, Arai AD, Levy SM et al. Quality of life after esophagectomy and endoscopic therapy for Barrett’s esophagus with high-grade dysplasia or intra-mucosal carcinoma. Gastrointest Endosc 2008;67:AB251. doi:10.​1016/​j.​gie.​2008.​03.​668.CrossRef
38.
42.
43.
go back to reference Peters F, Kara M, Rosmolen W et al. Poor results of 5-aminolevulinic acid-photodynamic therapy for residual high-grade dysplasia and early cancer in Barrett’s esophagus after endoscopic resection. Endoscopy 2005;37:418–424. doi:10.1055/s-2005-861198.PubMedCrossRef Peters F, Kara M, Rosmolen W et al. Poor results of 5-aminolevulinic acid-photodynamic therapy for residual high-grade dysplasia and early cancer in Barrett’s esophagus after endoscopic resection. Endoscopy 2005;37:418–424. doi:10.​1055/​s-2005-861198.PubMedCrossRef
44.
46.
go back to reference Ross A, Noffsinger A, Dye C et al. High prevalence of buried glands in mucosectomy specimens from patients with Barrett’s esophagus and high grade dysplasia or intramucosal carcinoma: implications for treatment and surveillance. Gastrointest Endosc 2007;65:AB137. doi:10.1016/j.gie.2007.03.160.CrossRef Ross A, Noffsinger A, Dye C et al. High prevalence of buried glands in mucosectomy specimens from patients with Barrett’s esophagus and high grade dysplasia or intramucosal carcinoma: implications for treatment and surveillance. Gastrointest Endosc 2007;65:AB137. doi:10.​1016/​j.​gie.​2007.​03.​160.CrossRef
50.
go back to reference Badreddine RJ, Wang KK, Prasad GA et al. Does endoscopic mucosal resection (EMR) affect subsequent esophagectomy? Gastrointest Endosc 2008;67:AB94. Badreddine RJ, Wang KK, Prasad GA et al. Does endoscopic mucosal resection (EMR) affect subsequent esophagectomy? Gastrointest Endosc 2008;67:AB94.
51.
go back to reference Overholt BF, Wang KK, Burdick JJ et al. Five-year efficacy and safety of photodynamic therapy with Photofrin in Barrett’s high-grade dysplasia. Gastrointest Endosc 2007;66:460–468. Overholt BF, Wang KK, Burdick JJ et al. Five-year efficacy and safety of photodynamic therapy with Photofrin in Barrett’s high-grade dysplasia. Gastrointest Endosc 2007;66:460–468.
52.
go back to reference Gondrie JJ, Pouw RE, Sondermeijer CM et al. Effective treatment of early Barrett’s neoplasia with stepwise circumferential and focal ablation using the HALO system. Endoscopy 2008;40:370–379. Gondrie JJ, Pouw RE, Sondermeijer CM et al. Effective treatment of early Barrett’s neoplasia with stepwise circumferential and focal ablation using the HALO system. Endoscopy 2008;40:370–379.
53.
go back to reference Greenwald BD, Horwhat JD, Abrams JA et al. Endoscopic cryotherapy ablation is safe and well-tolerated in Barrett’s esophagus, esophageal dysplasia and esophageal cancer. Gastrointest Endosc 2008;67:AB76. Greenwald BD, Horwhat JD, Abrams JA et al. Endoscopic cryotherapy ablation is safe and well-tolerated in Barrett’s esophagus, esophageal dysplasia and esophageal cancer. Gastrointest Endosc 2008;67:AB76.
57.
go back to reference Luketich JD, Alvelo-Rivera M, Buenaventura PO et al. Minimally invasive esophagectomy: Outcomes in 222 patients. Ann Surg 2003;238:486–495.PubMed Luketich JD, Alvelo-Rivera M, Buenaventura PO et al. Minimally invasive esophagectomy: Outcomes in 222 patients. Ann Surg 2003;238:486–495.PubMed
Metadata
Title
Endotherapy for Barrett’s Esophagus with High-Grade Dysplasia and Intramucosal Carcinoma
Author
Drew B. Schembre
Publication date
01-07-2009
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 7/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-0862-2

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