Top

Published in:

01-05-2012 | Gastrointestinal Oncology

Endoscopic Therapy for Barrett’s Esophagus: A Review of Its Emerging Role in Optimal Diagnosis and Endoluminal Therapy

Authors: Erik M. Dunki-Jacobs, MD, Robert C. G. Martin, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2012

Abstract

Barrett’s esophagus (BE) is a premalignant lesion known to sequentially progress to esophageal adenocarcinoma. Management of BE has changed significantly over the last 5 years with the development of endoscopic resection and ablation, which has replaced esophagectomy as the treatment of choice in BE with high-grade dysplasia. The aim of this review is to discuss the details of these new endotherapies in regards to response and durability and to define the role of these new therapies in the current management of BE.

Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97(2):142–6.PubMedCrossRef

National Cancer Institute. Esophageal cancer. http://www.cancer.gov/cancertopics/types/esophageal (2011). Accessed 3 Aug 2011.

Schlemper RJ, Riddell RH, Kato Y, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47(2):251–5.PubMedCrossRef

Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–31.PubMedCrossRef

Gilbert EW, Luna RA, Harrison VL, Hunter, JG. Barrett’s esophagus: a review of the literature. J Gastrointest Surg. 2011;15:708–18.PubMedCrossRef

Yousef F, Cardwell C, Cantwell MM, Galway K, Johnston BT, Murray L. The incidence of esophageal cancer and high-grade dysplasia in Barrett’s esophagus: a systematic review and meta-analysis. Am J Epidemiol. 2008;168(3):237–49.PubMedCrossRef

Sharma P, Falk GW, Weston AP, et al. Dysplasia and cancer in a large multicenter cohort of patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4(5):566–72.PubMedCrossRef

Coleman HG, Bhat S, Murray LJ, et al. Increasing incidence of Barrett’s oesophegus: a population-based study. Eur J Epidemiol. 2011;26(9):739–45.PubMedCrossRef

Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology. 2006;131(5):1392–9.PubMedCrossRef

10.

Wang KK, Sampliner RE, Practice Parameters Committee of the American College of Gastroenterology. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol. 2008;103(3):788–97.PubMedCrossRef

11.

Paull A, Trier JS, Dalton MD, et al. The histologic spectrum of Barrett’s esophagus. N Engl J Med. 1976;295(9):476–80.PubMedCrossRef

12.

Chandrasoma PT, Der R, Dalton P, Kobayashi G, Ma Y, Peters J, DeMeester T. Distribution and significance of epithelial types in columnar-lined esophagus. Am J Surg Pathol. 2001;25(9):1188–93.PubMedCrossRef

13.

Harrison R, Perry I, Haddadin W, et al. Detection of intestinal metaplasia in Barrett’s esophagus: an observational comparator study suggests the need for a minimum of eight biopsies. Am J Gastroenterol. 2007;102(6):1154–61.PubMedCrossRef

14.

Reid BJ, Blount PL, Feng Z, Levine DS. Optimizing endoscopic biopsy detection of early cancers in Barrett’s high-grade dysplasia. Am J Gastroenterol. 2000;95(11):3089–96.PubMedCrossRef

15.

Nigro JJ, Hagen JA, DeMeester TR, DeMeester SR, Theisen J, Peters JH, Kiyabu M. Occult esophageal adenocarcinoma: extent of disease and implications for effective therapy. Ann Surg. 1999;230(3):433–8.PubMedCrossRef

16.

DeMeester SR. Evaluation and treatment of superficial esophageal cancer. J Gastrointest Surg. 2010;14 Suppl 1:S94–100.PubMedCrossRef

17.

Wani S, Mathur SC, Curvers WL, et al. Greater interobserver agreement by endoscopic mucosal resection than biopsy samples in Barrett’s dysplasia. Clin Gastroenterol Hepatol. 2010;8(9):783–8.PubMedCrossRef

18.

Pech O, Behrens A, May A, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57:1200–6.PubMedCrossRef

19.

Ell C, May A, Pech OL, et al. Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer). Gastrointest Endosc. 2007;65(1):3–9.PubMedCrossRef

20.

Gan S, Watson DI. New endoscopic and surgical treatment options for early esophageal adenocarcinoma. J Gastroenterol Hepatol. 2010;25(9):1478–84.PubMedCrossRef

21.

Ginsberg GG. Endoscopic approaches to Barrett’s oesophagus with high-grade dysplasia/early mucosal cancer. Best Pract Res Clin Gastroenterol. 2008;22(4):751–72.PubMedCrossRef

22.

Kahaleh M, Van Laethem JL, Nagy N, et al. Long-term follow-up and factors predictive of recurrence in Barrett’s esophagus treated by argon plasma coagulation and acid suppression. Endoscopy. 2002;34(12):950–5.PubMedCrossRef

23.

Overholt BF, Wang KK, Burdick JS, et al. Five-year efficacy and safety of photodynamic therapy with Photofrin in Barrett’s high-grade dysplasia. Gastrointest Endosc. 2007; 66(3):460–8.PubMedCrossRef

24.

Overholt BF, Panjehpour M, Halberg DL. Photodynamic therapy for Barrett’s esophagus with dysplasia and/or early stage carcinoma: long-term results. Gastrointest Endosc. 2003;58(2):183–8.PubMedCrossRef

25.

Wani S, Puli SR, Shaheen NJ, et al. Esophageal adenocarcinoma in Barrett’s esophagus after endoscopic ablative therapy: a meta-analysis and systematic review. Am J Gastroenterol. 2009;104:502–13.PubMedCrossRef

26.

Basu KK, Pick B, Bale R, et al. Efficacy and one year follow up of argon plasma coagulation therapy for ablation of Barrett’s oesophagus: factors determining persistence and recurrence of Barrett’s epithelium. Gut. 2002;51(6):776–80.PubMedCrossRef

27.

Ban S, Mino M, Nishioka NS, et al. Histopathologic aspects of photodynamic therapy for dysplasia and early adenocarcinoma arising in Barrett’s esophagus. Am J Surg Pathol. 2004;28(11):1466–73.PubMedCrossRef

28.

Yeh RW, Triadafilopoulos G. Endoscopic therapy for Barrett’s esophagus. Gastrointest Endosc Clin North Am. 2005;15(3):377–97.CrossRef

29.

Sharma VK, Wang KK, Overholt BF, et al. Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc. 2007;65:185–95.PubMedCrossRef

30.

Fleischer DE, Overholt BF, Sharma VK, et al. Endoscopic ablation of Barrett’s esophagus: a multicenter study with 2.5-year followup. Gastrointest Endosc. 2008;68:867–76.PubMedCrossRef

31.

Fleischer DE, Overholt BF, Sharma VK, et al. Endoscopic radiofrequency ablation for Barrett’s esophagus: 5-year outcomes from a prospective multicenter trial. Endoscopy. 2010;42(10):781–9.PubMedCrossRef

32.

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

33.

Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–88.PubMedCrossRef

34.

Shaheen NJ, Overholt BF, Sampliner R, et al. Durability of radiofrequency ablation in Barrett’s esophagus with dysplasia. Gastroenterology. 2011;141(2):460–8.PubMedCrossRef

35.

Pouw RE, Gondrie JJ, Sondermeijer CM, et al. Eradication of Barrett esophagus with early neoplasia by radiofrequency ablation, with or without endoscopic resection. J Gastrointest Surg. 2008;12:1627–37.PubMedCrossRef

36.

Earlam R, Cunha-Melo JR. Oesophageal squamous cell carcinoma: a critical review of surgery. Br J Surg. 1980;67:381–90.PubMedCrossRef

37.

Muller JM, Erasmi H, Stelzner M, Zieren U, Pichlmaier H. Surgical therapy of oesophageal carcinoma. Br J Surg. 1990;77:845–57.PubMedCrossRef

38.

Jamieson GG, Mathew G, Ludemann R, et al. Postoperative mortality following oesophagectomy and problems in reporting its rate. Br J Surg. 2004;91:943–7.PubMedCrossRef

39.

Morita M, Nakanoko T, Fujinaka Y, et al. In-hospital mortality after a surgical resection for esophageal cancer: analysis of the associated factors and historical changes. Ann Surg Oncol. 2011;18:1757–65.PubMedCrossRef

40.

Pennathur A, Farkas A, Krasinskas AM, et al. Esophagectomy for T1 esophageal cancer: outcomes in 100 patients and implications for endoscopic therapy. Ann Thorac Surg. 2009;87:1048–55.PubMedCrossRef

41.

Pech O, Bollschweiler E, Manner H, et al. Comparison between endoscopic and surgical resection of mucosal esophageal adenocarcinoma in Barrett’s esophagus at two high-volume centers. Ann Surg. 2011;254(1):67–72.PubMedCrossRef

42.

Zehetner J, DeMeester SR, Hagen J. Endoscopic resection and ablation versus esophagectomy for high-grade dysplasia and intramucosal adenocarcinoma. J Thorac Cardiovasc Surg. 2011;141(1):39–47.PubMedCrossRef

43.

Sepesi B, Watson T, Zhou D, et al. Are endoscopic therapies appropriate for superficial submucosal esophageal adenocarcinoma? An analysis of esophagectomy specimens. J Am Coll Surg. 2010;210(4):418–27.PubMedCrossRef

44.

Ancona E, Rampado S, Cassaro M, et al. Prediction of lymph node status in superficial esophageal carcinoma. Ann Surg Oncol. 2008;15(11):3278–-88.PubMedCrossRef

45.

Anderson LA, Murray LJ, Murphy SJ, et al. Mortality in Barrett’s oesophagus: results from a population based study. Gut. 2003;52:1081–4.PubMedCrossRef

46.

Wani S, Falk GW, Post J, et al. Risk factors for progression of low-grade dysplasia in patients with Barrett’s esophagus. Gastroenterology. 2011;141(4):1179–1186.PubMedCrossRef

47.

Skacel M, Petras RE, Gramlich TL, et al. The diagnosis of low-grade dysplasia in Barrett’s esophagus and its implications for disease progression. Am J Gastroenterol. 2000;95:3383–7.PubMedCrossRef

48.

Gatenby P, Ramus J, Caygill C, et al. Routinely diagnosed low-grade dysplasia in Barrett’s oesophagus: a population-based study of natural history. Histopathology. 2009;54(7):814–9.PubMedCrossRef

49.

Lim CH, Treanor D, Dixon MF, Axon AT. Low-grade dysplasia in Barrett’s esophagus has a high risk of progression. Endoscopy. 2007;39(7):581–7.PubMedCrossRef

50.

Fleischer DE, Odze R, Overholt BF, et al. The case for endoscopic treatment of non-dysplastic and low-grade dysplastic Barrett’s Esophagus. Dig Dis Sci. 2010;55:1918–31.PubMedCrossRef

51.

Inadomi JM, Somsouk M, Madanick RD, et al. A cost-utility analysis of ablative therapy for Barrett’s esophagus. Gastroenterology. 2009;136:2101–14.PubMedCrossRef

52.

Gondrie JJ, Pouw RE, Sondermeijer CMT, et al. Stepwise circumferential and focal ablation of Barrett’s esophagus with high-grade dysplasia: results of the first prospective series of 11 patients. Endoscopy. 2008;40:359–69.PubMedCrossRef

53.

Gondrie JJ, Pouw RE, Sondermeijer CMT, et al. Effective treatment of early Barrett’s neoplasia with stepwise circumferential and focal ablation using the HALO system. Endoscopy. 2008;40:370–79.PubMedCrossRef

54.

Sharma VK, Jae Kim H, Das A, et al. A prospective pilot trial of ablation of Barrett’s esophagus with low-grade dysplasia using stepwise circumferential and focal ablation (HALO system). Endoscopy. 2008;40:380–7.PubMedCrossRef

Title: Endoscopic Therapy for Barrett’s Esophagus: A Review of Its Emerging Role in Optimal Diagnosis and Endoluminal Therapy
Authors: Erik M. Dunki-Jacobs, MD
Robert C. G. Martin, MD, PhD
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-2163-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic Therapy for Barrett’s Esophagus: A Review of Its Emerging Role in Optimal Diagnosis and Endoluminal Therapy

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2012

A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

Carcinoma of the Ampulla of Vater: Patterns of Failure Following Resection and Benefit of Chemoradiotherapy

Outcome of Microscopic Incomplete Resection (R1) of Colorectal Liver Metastases in the Era of Neoadjuvant Chemotherapy

Cytoreductive Surgery with Selective Versus Complete Parietal Peritonectomy Followed by Hyperthermic Intraperitoneal Chemotherapy in Patients with Diffuse Malignant Peritoneal Mesothelioma: A Controlled Study

Adverse Effects of Smoking on Postoperative Outcomes in Cancer Patients

Neoadjuvant/Preoperative Gemcitabine for Patients with Localized Pancreatic Cancer: A Meta-analysis of Prospective Studies