title: How is early Barrett's cancer currently diagnosed and treated in Western Europe? Results of a survey at 52 university hospitals in eight Western European countries.
abstract: OBJECTIVE
  Endoscopic treatment is increasingly being accepted for early Barrett's cancer (EBC), as it is associated with few complications, excellent long-term results, and almost no mortality. This study investigated current standards and treatment strategies for EBC in eight countries in Western Europe.
  
  
  METHODS
  A standardized questionnaire with questions on the endoscopic diagnosis, staging, and treatment of EBC was developed and sent to 107 university gastroenterology departments. The data were analyzed anonymously.
  
  
  RESULTS
  The response rate was 49 % (52/107). For work-up of early Barrett's neoplasia, 67 % of hospitals use high-resolution endoscopes, with routine four-quadrant and targeted biopsies of visible lesions in 94 % of the cases. Narrow-band imaging and chromoendoscopy are used in 67 % of the cases, and other advanced imaging and staining techniques in 65 %. Before treatment, 63 % of the respondents recommended conventional endosonography, 6 % miniprobe endosonography, and 19 % both. Endoscopic resection is carried out at 98 % of the hospitals. Argon plasma coagulation is used for ablation in 52 % of the cases and radiofrequency ablation in 27 %. An 80-year-old patient with localized mucosal EBC would be treated endoscopically in all of the hospitals. Endoscopic therapy was recommended for 50-year-old patients with mucosal EBC by 87 % of the hospitals; esophageal resection was recommended for multifocal EBC by 15 % in 80-year-old patients, by 63 % in 50-year-old patients and by 44 % in patients with incipient submucosal infiltration.
  
  
  CONCLUSIONS
  About two-thirds of the university hospitals use high-resolution endoscopy and advanced imaging. Endoscopic therapy is the accepted standard for treating localized mucosal Barrett's cancer in Western Europe; esophageal resection is recommended by the majority (63 %) for a young patient with multifocal EBC.
authors: Innere Medizin 2, HSK Wiesbaden, Germany.
authors: D
authors: D
authors: Heuberger
authors: H
authors: H
authors: Manner
authors: C
authors: C
authors: Ell
authors: O
authors: O
authors: Pech
mesh_terms: D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D016896:Treatment Outcome