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Study shows long-term success rates for eradication of Barrett's esophagus after endoluminal therapies
Date:2/12/2013

subsequent recurrent intestinal metaplasia was detected in 48 (35 percent) and dysplasia in 12 (9 percent).

Among those who achieved only complete elimination of dysplasia, recurrent dysplasia was detected in six of 19 patients (32 percent). Statistical analysis showed that multifocal dysplasia and patient's age were risk factors for dysplasia and carcinoma recurrence, and complete elimination of intestinal metaplasia was a protective factor. Retreatment achieved remission in 90 percent of cases. Forty-two patients (23.9 percent) had complications, including 21 with stricture (11.9 percent) and one treatment-related death. Most adverse events were minor and responded to endoscopic or supportive therapy.

The researchers concluded that multiple-mode endoluminal therapy, combining resection and ablation techniques, for patients with BE and HGD and/or early mucosal cancer, with the intention of achieving complete eradication of all intestinal metaplasia can achieve a high success rate with durable results and low risk of morbidity. However, endoluminal therapy typically requires multiple treatment sessions over many months, life-long proton-pump inhibitor therapy, and a commitment to endoscopic surveillance after successful eradication. Although the risk of dysplasia or cancer recurrence is low, it is increased when multifocal dysplasia is detected before and during treatment. Additionally, intestinal metaplasia recurrence is detected in one-third of successfully treated patients, and it can occur long after initial eradication was achieved. Therefore, endoscopic surveillance even after successful eradication is required.


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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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