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Endoscopic circumferential ablation promising for Barrett's esophagus with high-grade dysplasia
Date:7/31/2008

OAK BROOK, Ill. July 31, 2008 A multicenter U.S. registry study examining the treatment of Barrett's esophagus (BE) with high-grade dysplasia (HGD) showed that in 92 patients treated with endoscopic circumferential ablation who had at least one follow-up biopsy session, 90.2 percent were free of HGD at an average of one-year follow-up. This registry is the first to report on the use of circumferential ablation for BE HGD. The study appears in the July issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Barrett's esophagus is a condition where the lining of the esophagus changes because of chronic inflammation, generally due to gastroesophageal reflux disease (GERD). Definitive diagnosis requires a biopsy, taken at upper endoscopy, demonstrating replacement of the normal cell lining with one more like the cell lining of the small intestine. This is also known as intestinal metaplasia (IM). Barrett's esophagus itself has no specific symptoms, but this change can increase the risk of esophageal adenocarcinoma (a type of esophageal cancer). Barrett's esophagus can be readily detected during an upper endoscopy, but must be confirmed by biopsies. The intent is to diagnose this condition, treat it medically, and follow it over time before a cancer has a chance to develop. If biopsies detect dysplasia (a precancerous change in tissue), then either surgery, close endoscopic surveillance (doing endoscopies at regular intervals with biopsies) or other treatments will be recommended. Once high-grade dysplasia is present, the risk of developing adenocarcinoma is two percent to 10 percent per patient, per year. Given the rising incidence of esophageal adenocarcinoma and the poor prognosis once cancer develops, aggressive therapy of the precancerous changes may be beneficial.

"This patient registry assessed the safety and effectiveness of endoscopic
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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