Tags

Type your tag names separated by a space and hit enter

Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus.
Clin Gastroenterol Hepatol. 2003 Jul; 1(4):252-7.CG

Abstract

BACKGROUND & AIMS

Although esophagectomy is the standard of care for treating early adenocarcinoma in Barrett's esophagus, the procedure is associated with significant morbidity and mortality. For these patients, the multimodal approach of endoscopic mucosal resection and photodynamic therapy (EMR/PDT) may be a viable, less invasive option.

METHODS

A retrospective review (1996-2001) of all patients undergoing either combined EMR/PDT group or esophagectomy (SURG) for early-stage Barrett's adenocarcinoma was performed. Data were collected on patient demographics, tumor staging, procedure-related morbidity and mortality, persistence or recurrence of cancer, and cancer-related deaths after therapy. Differences in outcomes between the 2 groups were assessed.

RESULTS

Twenty-four patients were identified in the EMR/PDT group and 64 in the SURG group. The SURG group was found to have a significantly higher procedure-related complication rate compared with the EMR/PDT group (31 vs. 4; P < 0.01). There were no procedure-related deaths in the EMR/PDT group, whereas one death occurred in the SURG group as a result of complications. Eighty-three percent of patients (20 of 24) in the EMR/PDT group and all patients in the SURG group remained free of cancer over a follow-up of 12 +/- 2 and 19 +/- 3 months, respectively. Four patients in the EMR/PDT group failed to respond to therapy; 2 of them underwent alternate therapies and are free of disease, whereas the other 2 died of unrelated causes.

CONCLUSIONS

The combination of EMR/PDT seems to be a viable and less morbid alternative to standard esophagectomy in patients presenting with early Barrett's esophageal adenocarcinoma. A prospective randomized, controlled trial of EMR/PDT compared with esophagectomy for managing early adenocarcinoma in Barrett's esophagus may be warranted.

Authors+Show Affiliations

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Graduate School of Medicine, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15017665

Citation

Pacifico, Rodney J., et al. "Combined Endoscopic Mucosal Resection and Photodynamic Therapy Versus Esophagectomy for Management of Early Adenocarcinoma in Barrett's Esophagus." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 1, no. 4, 2003, pp. 252-7.
Pacifico RJ, Wang KK, Wongkeesong LM, et al. Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus. Clin Gastroenterol Hepatol. 2003;1(4):252-7.
Pacifico, R. J., Wang, K. K., Wongkeesong, L. M., Buttar, N. S., & Lutzke, L. S. (2003). Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 1(4), 252-7.
Pacifico RJ, et al. Combined Endoscopic Mucosal Resection and Photodynamic Therapy Versus Esophagectomy for Management of Early Adenocarcinoma in Barrett's Esophagus. Clin Gastroenterol Hepatol. 2003;1(4):252-7. PubMed PMID: 15017665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus. AU - Pacifico,Rodney J, AU - Wang,Kenneth K, AU - Wongkeesong,Louis-Michel, AU - Buttar,Navtej S, AU - Lutzke,Lori S, PY - 2004/3/16/pubmed PY - 2004/4/24/medline PY - 2004/3/16/entrez SP - 252 EP - 7 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 1 IS - 4 N2 - BACKGROUND & AIMS: Although esophagectomy is the standard of care for treating early adenocarcinoma in Barrett's esophagus, the procedure is associated with significant morbidity and mortality. For these patients, the multimodal approach of endoscopic mucosal resection and photodynamic therapy (EMR/PDT) may be a viable, less invasive option. METHODS: A retrospective review (1996-2001) of all patients undergoing either combined EMR/PDT group or esophagectomy (SURG) for early-stage Barrett's adenocarcinoma was performed. Data were collected on patient demographics, tumor staging, procedure-related morbidity and mortality, persistence or recurrence of cancer, and cancer-related deaths after therapy. Differences in outcomes between the 2 groups were assessed. RESULTS: Twenty-four patients were identified in the EMR/PDT group and 64 in the SURG group. The SURG group was found to have a significantly higher procedure-related complication rate compared with the EMR/PDT group (31 vs. 4; P < 0.01). There were no procedure-related deaths in the EMR/PDT group, whereas one death occurred in the SURG group as a result of complications. Eighty-three percent of patients (20 of 24) in the EMR/PDT group and all patients in the SURG group remained free of cancer over a follow-up of 12 +/- 2 and 19 +/- 3 months, respectively. Four patients in the EMR/PDT group failed to respond to therapy; 2 of them underwent alternate therapies and are free of disease, whereas the other 2 died of unrelated causes. CONCLUSIONS: The combination of EMR/PDT seems to be a viable and less morbid alternative to standard esophagectomy in patients presenting with early Barrett's esophageal adenocarcinoma. A prospective randomized, controlled trial of EMR/PDT compared with esophagectomy for managing early adenocarcinoma in Barrett's esophagus may be warranted. SN - 1542-3565 UR - https://www.unboundmedicine.com/medline/citation/15017665/Combined_endoscopic_mucosal_resection_and_photodynamic_therapy_versus_esophagectomy_for_management_of_early_adenocarcinoma_in_Barrett's_esophagus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542356503001290 DB - PRIME DP - Unbound Medicine ER -