Photodynamic therapy and endoscopic mucosal resection for Barrett's dysplasia and early esophageal adenocarcinoma

H. C. Wolfsen, Lois L. Hemminger, Massimo Raimondo, Timothy A. Woodward

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: Endoscopic mucosal resection (EMR) and endoscopic ablation with porfimer sodium photodynamic therapy (PDT) have recently been combined to improve the accuracy of histologic staging and remove superficial carcinomas. Materials and Methods: All patients with Barrett's esophagus and high-grade dysplasia were evaluated with computed tomography and endosonography. Patients with nodular or irregular folds underwent EMR followed by PDT. Results: In three patients, endoscopic mucosal resection upstaged the diagnosis to mucosal adenocarcinoma (T1N0M0). PDT successfully ablated the remaining glandular mucosa. Complications were limited to transient chest discomfort and odynophagia. Conclusions: The use of EMR resection in Barrett's high-grade dysplasia patients with mucosal irregularities resulted in histologic upstaging to mucosal adenocarcinoma, requiring higher laser light doses for PDT. PDT after EMR appears to be safe and effective for the complete elimination of Barrett's mucosal adenocarcinoma. EMR should be strongly considered for Barrett's dysplasia patients being evaluated for endoscopic ablation therapy.

Original languageEnglish (US)
Pages (from-to)827-830
Number of pages4
JournalSouthern medical journal
Volume97
Issue number9
DOIs
StatePublished - Sep 1 2004

Keywords

  • Barrett's esophagus
  • Endoscopic mucosal resection
  • Endoscopic ultrasound
  • Esophageal cancer
  • Photodynamic therapy

ASJC Scopus subject areas

  • Medicine(all)

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