Management of Dysplastic Barrett's Esophagus and Early Esophageal Adenocarcinoma

Gastroenterol Clin North Am. 2022 Sep;51(3):485-500. doi: 10.1016/j.gtc.2022.06.004. Epub 2022 Aug 30.

Abstract

While patients with Barrett's esophagus without dysplasia may benefit from endoscopic surveillance, those with low-grade dysplasia may be managed with either endoscopic surveillance or endoscopic eradication. Patients with Barrett's esophagus with high-grade dysplasia and/or intramucosal adenocarcinoma will generally require endoscopic eradication therapy. The management of Barrett's esophagus with dysplasia and early esophageal adenocarcinoma is predominantly endoscopic, with multiple effective methods available for the resection of raised neoplasia and ablation of flat neoplasia. High-dose proton-pump inhibitor therapy is advised during the treatment of Barrett's esophagus with dysplasia and early esophageal adenocarcinoma. After the endoscopic eradication of Barrett's esophagus and associated neoplasia, surveillance is required for the diagnosis and retreatment of recurrence or progression.

Keywords: Adenocarcinoma; Barrett’s esophagus; Cryotherapy; Dysplasia; Endoscopic eradication therapy; Endoscopic mucosal resection; Radiofrequency ablation.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma* / diagnosis
  • Adenocarcinoma* / etiology
  • Adenocarcinoma* / therapy
  • Barrett Esophagus* / diagnosis
  • Barrett Esophagus* / pathology
  • Barrett Esophagus* / therapy
  • Esophageal Neoplasms* / diagnosis
  • Esophageal Neoplasms* / etiology
  • Esophageal Neoplasms* / therapy
  • Esophagoscopy
  • Humans
  • Hyperplasia
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Proton Pump Inhibitors

Supplementary concepts

  • Adenocarcinoma Of Esophagus