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Curative treatment for high-grade intraepithelial neoplasia in Barrett's esophagus.
Endoscopy. 2005 Oct; 37(10):999-1005.E

Abstract

BACKGROUND AND STUDY AIMS

The incidence of premalignant and malignant lesions in specialized intestinal metaplasia of the esophagus has increased dramatically in the industrialized world in recent years. This report evaluates the efficacy and safety of local endoscopic therapy for high-grade intraepithelial neoplasia (HGIN) in Barrett's esophagus.

PATIENTS AND METHODS

Over a 5-year period between October 1996 and September 2001, a total of 379 patients were referred with a suspicion of early Barrett's cancer. In a prospective study, 44 patients with HGIN in Barrett's esophagus were selected for local endoscopic treatment. Endoscopic resection was carried out in 14 patients in whom the HGIN was re-detectable, and 27 patients in whom the HGIN was not re-detectable underwent photodynamic therapy (PDT). Endoscopic resection and PDT were combined in three patients.

RESULTS

Complete remission was achieved in 43 of the 44 patients (97.7 %). No major complications occurred. A mean of 1 session was needed to achieve complete local remission. During a mean follow-up period of 36 months (range 7 - 61 months), recurrent or metachronous lesions were observed in six patients (17.1 %), all of whom received a second successful endoscopic treatment.

CONCLUSIONS

Endoscopic therapy is a safe alternative treatment regimen for HGIN in Barrett's esophagus, providing a middle way between the widely promulgated options of a "watch-and-wait" policy and radical esophagectomy.

Authors+Show Affiliations

Department of Internal Medicine II, HSK, Wiesbaden, Germany. ell.hsk-wiesbaden@arcor.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16189774

Citation

Behrens, A, et al. "Curative Treatment for High-grade Intraepithelial Neoplasia in Barrett's Esophagus." Endoscopy, vol. 37, no. 10, 2005, pp. 999-1005.
Behrens A, May A, Gossner L, et al. Curative treatment for high-grade intraepithelial neoplasia in Barrett's esophagus. Endoscopy. 2005;37(10):999-1005.
Behrens, A., May, A., Gossner, L., Günter, E., Pech, O., Vieth, M., Stolte, M., Seitz, G., & Ell, C. (2005). Curative treatment for high-grade intraepithelial neoplasia in Barrett's esophagus. Endoscopy, 37(10), 999-1005.
Behrens A, et al. Curative Treatment for High-grade Intraepithelial Neoplasia in Barrett's Esophagus. Endoscopy. 2005;37(10):999-1005. PubMed PMID: 16189774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Curative treatment for high-grade intraepithelial neoplasia in Barrett's esophagus. AU - Behrens,A, AU - May,A, AU - Gossner,L, AU - Günter,E, AU - Pech,O, AU - Vieth,M, AU - Stolte,M, AU - Seitz,G, AU - Ell,C, PY - 2005/9/29/pubmed PY - 2006/1/6/medline PY - 2005/9/29/entrez SP - 999 EP - 1005 JF - Endoscopy JO - Endoscopy VL - 37 IS - 10 N2 - BACKGROUND AND STUDY AIMS: The incidence of premalignant and malignant lesions in specialized intestinal metaplasia of the esophagus has increased dramatically in the industrialized world in recent years. This report evaluates the efficacy and safety of local endoscopic therapy for high-grade intraepithelial neoplasia (HGIN) in Barrett's esophagus. PATIENTS AND METHODS: Over a 5-year period between October 1996 and September 2001, a total of 379 patients were referred with a suspicion of early Barrett's cancer. In a prospective study, 44 patients with HGIN in Barrett's esophagus were selected for local endoscopic treatment. Endoscopic resection was carried out in 14 patients in whom the HGIN was re-detectable, and 27 patients in whom the HGIN was not re-detectable underwent photodynamic therapy (PDT). Endoscopic resection and PDT were combined in three patients. RESULTS: Complete remission was achieved in 43 of the 44 patients (97.7 %). No major complications occurred. A mean of 1 session was needed to achieve complete local remission. During a mean follow-up period of 36 months (range 7 - 61 months), recurrent or metachronous lesions were observed in six patients (17.1 %), all of whom received a second successful endoscopic treatment. CONCLUSIONS: Endoscopic therapy is a safe alternative treatment regimen for HGIN in Barrett's esophagus, providing a middle way between the widely promulgated options of a "watch-and-wait" policy and radical esophagectomy. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/16189774/Curative_treatment_for_high_grade_intraepithelial_neoplasia_in_Barrett's_esophagus_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2005-870352 DB - PRIME DP - Unbound Medicine ER -