Endoscopy a viable alternative to surgery for Barrett's esophagus patients — 3 insights

A study, presented at World Congress of Gastroenterology 2017, examined if endoscopic therapy would be effective for Barrett's esophagus patients with intramucosal carcinoma as it is for those with high-grade dysplasia.

Rajesh Krishnamoorthi, MD, from Seattle-based Virginia Mason Medical Center, and colleagues assessed 276 Barrett's esophagus patients. Seventy had intramucosal carcinoma and 206 had high-grade dysplasia. Patients underwent an endoscopy at one of 10 international centers.

Here's what they found:

1. Rates of complete intestinal metaplasia eradication were not significantly different between the carcinoma group (81 percent) and the dysplasia group (87 percent). Rates of complete dysplasia eradication were also similar at 84 percent and 90 percent respectively.

2. Researchers conducted a multivariate analysis adjusting for age, sex and length of Barrett's esophagus and difference in eradication rates between the two groups were still not significant.

3. There was no significant difference between the recurrence of Barrett's esophagus in the carcinoma group (44 percent) or the dysplasia group (35 percent) either.

Researchers concluded, "In this large, well-defined cohort of Barrett's esophagus patients, the effectiveness of endoscopic therapy for intramucosal cancer is comparable to that for high-grade dysplasia."

WCG 2017 was Oct. 13 to Oct. 18 in Orlando, Fla.

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