+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Curative endoscopic therapy of early cancer and high grade neoplasia in barretts esophagus additional endoscopic ablation of barretts esophagus can reduce the risk of recurrent carcinomas



Curative endoscopic therapy of early cancer and high grade neoplasia in barretts esophagus additional endoscopic ablation of barretts esophagus can reduce the risk of recurrent carcinomas



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No W1270



Backround and Aims: Endoscopic therapy (ET) in Early cancer (EC) and High-Grade Neoplasia (HGN) in Barrett's Esopagus (BE) offers a new promising option with curative intention. Metachronous lesions within the residual Barrett`s segments are one of the major risks of endoscopic therapy. In the present study we compared two different therapy strategies: Patients who underwent ET until achieving complete remission of HGN/EC were either only controlled endoscopically during the follow-up or received additional ablation therapy of the residual metaplastic Barrett`s epithelium. Methods: During June 1996 until September 1999 115 patients (group A), between October 1999 and September 2001 170 patients (group B) with endoscopically or histologically proven or suspected EC/HGN underwent ET in our department. Group A: Endoscopic resection (ER) was used in 70 patients and photodynamic therapy (PDT) was used in 32 patients. The two procedures were combined in 10 patients. Three patients underwent primary treatment with argon plasma coagulation (APC). While in group B 148 patients underwent ER, 21 PDT. Combined therapy was done in 1 patient. Actually in 70 patients (group B) an additional endoscopic ablation of BE was done. Results: Complete local remission was achieved in 98% of the group A patients, while 80% of group B patients are currently in remission. 37 patients of group B are still under therapy. The method associated mortality was in both groups 0%. There were no major complications (stenosis/bleeding: haemoglobin fall > 2g/dl) in group A. In group B 4 major complications in 3 patients (2 %) occurred including one perforation (no surgery necessary) and 3 bleedings with reduction in haemoglobin level (>2g/dl) (n.s.) Comparing both groups with regard to a difference relating to the rate of metachronous neoplasias we chose an average follow-up-period of 20 months in both groups for the comparison. A local recurrence of HGN/EC was found in 14% in group A, 7% in group B (n < 0.01) Conclusions: ET is a minimal invasive and safe therapy. There is a hint that additional endoscopic ablation of BE in patients who achieved complete locale remission can reduce the risk metachronous neoplasias. The findings of the 20 months follow-up have to be proven by long-term results.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 034667706

Download citation: RISBibTeXText


Related references

Long term results of local endoscopic therapy for intraepithelial high grade neoplasia and early adenocarcinoma in barretts esophagus. Digestive Disease Week Abstracts & Itinerary Planner : Abstract No 691, 2003

Acute-phase and long-term results of local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barretts esophagus. Gastroenterology 122(4 Suppl 1): A-287, 2002

Predictors of progression to cancer in barretts esophagus endoscopic lesions arising from barretts epithelium are not independently associated with increased risk. Digestive Disease Week Abstracts & Itinerary Planner : Abstract No W1302, 2003

Su1121 Endoscopic Submucosal Dissection (Esd) As A Salvage Therapy For Patients With Recurrece Or Progression Of BarrettS Esophagus (Be) Related Early Neoplasia After Standard Endoscopic Management Is Feasible And Safe : AUs Multi-Center Study. Gastrointestinal Endoscopy 87(6): Ab281-Ab282, 2018

A systematic endoscopic biopsy protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barretts esophagus. Gastroenterology 104(4 Suppl. ): A420, 1993

Predictors Of Incomplete Response To Endoscopic Eradication Therapy: Results From The Treatment With Resection And Endoscopic Ablation Techniques For BarrettS Esophagus (Treat-Be) Consortium. Gastrointestinal Endoscopy 89(6): Ab100-Ab101, 2019

Endoscopic appearance and extent of high-grade dysplasia in Barretts esophagus can predict the presence of cancer at esophagectomy. American Journal of Gastroenterology 98(9 Suppl.): S28, 2003

Endoscopic ultrasonography in the assessment of Barretts esophagus with high grade dysplasia or carcinoma. Gastroenterology 110(4 Suppl. ): A611, 1996

Photodynamic therapy of Barretts esophagus with high-grade dysplasia and early cancer. Gastroenterology 114(4 Part 2): A137, 1998

Dose escalation of proton pump inhibitor therapy during endoscopic ablation of Barretts esophagus. American Journal of Gastroenterology 98(9 Suppl.): S37-S38, 2003

Endoscopic fluorescence detection of high and low grade dysplasia in Barretts esophagus after sensitization with 5-amino levulinic acid. Gastroenterology 116(4 Part 2): A252, 1999

The impact of endoscopic biopsy surveillance of Barretts esophagus on pathological stage and postoperative survival of Barretts carcinoma. Gastroenterology 112(4 Suppl. ): A672, 1997

Endoscopic mucosal resection for Barretts esophagus-related neoplasia. Expert Review of Gastroenterology & Hepatology 1(1): 11-14, 2007

Barretts esophagus with severe dysplasia or early cancer Results of endoscopic mucosectomy in 17 patients. Gastroenterology 118(4 Suppl 2 Part 1): A221, 2000

High grade dysplasia in barretts esophagus is associated with early cancer. Gastroenterology 102(4 Part 2): A355, 1992