Management of Barrett's esophagus and early esophageal cancer: update on endoscopic treatment strategies.
Barrett's esophagus represents the strongest known risk factor for developing esophageal adenocarcinoma. The traditional management strategy for identifying and managing Barrett's esophagus involves screening and endoscopic surveillance to identify early stage, curable carcinoma. Recently, endoscopic eradication therapy has emerged to achieve the complete eradication of Barrett's esophagus and intramucosal cancer to prevent the development of invasive cancer with lymphatic spread. Randomized trials have demonstrated the efficacy of these approaches to reduce the progression to cancer, and endoscopic eradication therapy has become the preferred treatment approach for patients with high-grade dysplasia, and may be utilized for management of low-grade dysplasia as well. Owing to excellent eradication rates and favorable side effect profile, radiofrequency ablation has emerged as the ablative strategy of choice for patients undergoing endoscopic eradication therapy.
Division of General and Gastrointestinal Surgery, The Ohio State University Wexner Medical Center Columbus, OH, USA - kyle.perry@osumc.edu.
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