Endoscopic therapy for early esophageal cancer and premalignant lesions in barrett's esophagus

The major medical consequence of Barrett's esophagus (BE) is the potential risk of development of esophageal adenocarcinoma. It is the management of this cancer risk and early cancers that is the focus of endoscopic therapies. As the risk of cancer increases, the types of endoscopic therapies that can be applied become more invasive. These therapies involve removal of the esophageal mucosa and portions of the submucosa, thermal therapies to cauterize the neoplastic tissue, and the use of photochemical therapies that cause localized tissue necrosis. Case series suggest that these treatments are effective and in selected patients can be used in lieu of surgery or in patients who are not surgical candidates. However, randomized controlled trials are lacking.