Endoscopic management of dysplasia and early oesophageal cancer

Best Pract Res Clin Gastroenterol. 2018 Oct-Dec:36-37:27-36. doi: 10.1016/j.bpg.2018.11.003. Epub 2018 Nov 23.

Abstract

In the past decade there have been technological advances in Endoscopic Eradication Therapy (EET) for the management of patients with oesophageal neoplasia and early cancer. Multiple endoscopic techniques now exist for both squamous and Barrett's oesophagus associated neoplasia or early cancer. A fundamental aspect of endotherapy is removal of the target lesion by endoscopic mucosal resection, or endosopic submucosal dissection. Residual tissue is subsequently ablated to remove the risk of recurrence. The most validated technique for Barrett's oesophagus is radiofrequency ablation, but other techniques such as hybrid-APC and cryotherapy also show good results. This chapter will discuss the evolution of EET, and which patients are most likely to benefit. It will also explore the evidence behind the success of different techniques and provide practical advice on how to carry out the endoscopic techniques with a focus on radiofrequency ablation and endoscopic mucosal resection in particular.

Keywords: Barrett's oesophagus; Early adenocarcinoma; Endoscopic resection; High-grade dysplasia; Low-grade dysplasia; Radiofrequency ablation.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / surgery
  • Barrett Esophagus / pathology
  • Barrett Esophagus / surgery
  • Catheter Ablation / methods
  • Endoscopic Mucosal Resection / methods*
  • Esophageal Neoplasms / surgery
  • Esophageal Squamous Cell Carcinoma / surgery
  • Esophagoscopy / methods*
  • Humans
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery*

Supplementary concepts

  • Adenocarcinoma Of Esophagus