Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus

Kenneth Ke Ning Wang, J. M. Tian, E. Gorospe, J. Penfield, Prasad G Iyer, T. Goddard, M. Wongkeesong, Navtej Singh Buttar, L. Lutzke, S. Krishnadath

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial. The best candidates for treatment include compliant patients that have relatively short segments of Barrett's esophagus, an anatomically straight segment, lack of nodularity, and an intact p16. However, even with excellent long-term results similar to surgical resection, the risk of recurrence is present in over 14% of patients, which indicates that there will be a need to continue surveillance endoscopy in these patients.

Original languageEnglish (US)
Pages (from-to)349-355
Number of pages7
JournalDiseases of the Esophagus
Volume25
Issue number4
DOIs
StatePublished - May 2012

Fingerprint

Barrett Esophagus
Neoplasms
Chromosomal Instability
Photochemotherapy
Radio
Endoscopy
Therapeutics
Randomized Controlled Trials
Recurrence

Keywords

  • Ablation
  • Barrett's esophagus
  • Esophageal cancer
  • Mucosal resection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus. / Wang, Kenneth Ke Ning; Tian, J. M.; Gorospe, E.; Penfield, J.; Iyer, Prasad G; Goddard, T.; Wongkeesong, M.; Buttar, Navtej Singh; Lutzke, L.; Krishnadath, S.

In: Diseases of the Esophagus, Vol. 25, No. 4, 05.2012, p. 349-355.

Research output: Contribution to journalArticle

Wang, KKN, Tian, JM, Gorospe, E, Penfield, J, Iyer, PG, Goddard, T, Wongkeesong, M, Buttar, NS, Lutzke, L & Krishnadath, S 2012, 'Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus', Diseases of the Esophagus, vol. 25, no. 4, pp. 349-355. https://doi.org/10.1111/j.1442-2050.2012.01342.x
Wang, Kenneth Ke Ning ; Tian, J. M. ; Gorospe, E. ; Penfield, J. ; Iyer, Prasad G ; Goddard, T. ; Wongkeesong, M. ; Buttar, Navtej Singh ; Lutzke, L. ; Krishnadath, S. / Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus. In: Diseases of the Esophagus. 2012 ; Vol. 25, No. 4. pp. 349-355.
@article{6626f9927de6474896d6f5b01e6952a3,
title = "Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus",
abstract = "The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial. The best candidates for treatment include compliant patients that have relatively short segments of Barrett's esophagus, an anatomically straight segment, lack of nodularity, and an intact p16. However, even with excellent long-term results similar to surgical resection, the risk of recurrence is present in over 14{\%} of patients, which indicates that there will be a need to continue surveillance endoscopy in these patients.",
keywords = "Ablation, Barrett's esophagus, Esophageal cancer, Mucosal resection",
author = "Wang, {Kenneth Ke Ning} and Tian, {J. M.} and E. Gorospe and J. Penfield and Iyer, {Prasad G} and T. Goddard and M. Wongkeesong and Buttar, {Navtej Singh} and L. Lutzke and S. Krishnadath",
year = "2012",
month = "5",
doi = "10.1111/j.1442-2050.2012.01342.x",
language = "English (US)",
volume = "25",
pages = "349--355",
journal = "Diseases of the Esophagus",
issn = "1120-8694",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Medical and endoscopic management of high-grade dysplasia in Barrett's esophagus

AU - Wang, Kenneth Ke Ning

AU - Tian, J. M.

AU - Gorospe, E.

AU - Penfield, J.

AU - Iyer, Prasad G

AU - Goddard, T.

AU - Wongkeesong, M.

AU - Buttar, Navtej Singh

AU - Lutzke, L.

AU - Krishnadath, S.

PY - 2012/5

Y1 - 2012/5

N2 - The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial. The best candidates for treatment include compliant patients that have relatively short segments of Barrett's esophagus, an anatomically straight segment, lack of nodularity, and an intact p16. However, even with excellent long-term results similar to surgical resection, the risk of recurrence is present in over 14% of patients, which indicates that there will be a need to continue surveillance endoscopy in these patients.

AB - The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial. The best candidates for treatment include compliant patients that have relatively short segments of Barrett's esophagus, an anatomically straight segment, lack of nodularity, and an intact p16. However, even with excellent long-term results similar to surgical resection, the risk of recurrence is present in over 14% of patients, which indicates that there will be a need to continue surveillance endoscopy in these patients.

KW - Ablation

KW - Barrett's esophagus

KW - Esophageal cancer

KW - Mucosal resection

UR - http://www.scopus.com/inward/record.url?scp=84862815636&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862815636&partnerID=8YFLogxK

U2 - 10.1111/j.1442-2050.2012.01342.x

DO - 10.1111/j.1442-2050.2012.01342.x

M3 - Article

C2 - 22409514

AN - SCOPUS:84862815636

VL - 25

SP - 349

EP - 355

JO - Diseases of the Esophagus

JF - Diseases of the Esophagus

SN - 1120-8694

IS - 4

ER -