Endoluminal treatment of Barrett’s esophagus has become the preferred option for initial intervention for advanced neoplasia without invasive carcinoma. Data from abstracts presented at Digestive Disease Week 2008 provide greater insight into optimal use of existing techniques and an early look at potential next generation therapies. Results from the AIM Dysplasia trial describe a larger study with longer post-treatment surveillance highlighting the efficacy and tolerability of radiofrequency ablation, while early results from liquid nitrogen cryotherapy studies suggest a potential to obtain similar eradication results with very high tolerability. Endoscopic resection, despite its risks, remains a popular option for focal as well as more widespread resection of Barrett’s mucosa. Additional abstracts highlight novel approaches to ablation and resection. Enhanced imaging techniques and molecular marker analysis also appear to improve treatment outcomes. However, time and further studies of combined approaches to diagnosis and eradication are necessary to optimize treatment algorithms.
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Bhat, Y.M., Brensinger, C.M. and Ginsberg, G.G. ( 2008) Endoluminal resection (ELR) with the Duette multi-band mucosectomy system is safe, efficacious and enhances diagnosis and staging in highly dysplastic Barrett’s. Gastrointest Endosc67: AB188.
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Bumgarner, J.M., Panjehpour, M., Long, M., Dellon, E.S., Overholt, B.F. and Shaheen, N.J. ( 2008) Comparison of catheter-based radiofrequency ablation and photodynamic therapy for Barrett’s esophagus. Digestive Disease Week 2008. Gastroenterology134(Suppl. 1): A436-.
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Canto, M.I., Dunbar, K.B., Okolo, P., Jagannath, S.B. and Kantsevoy, S.V. ( 2008) Low flow CO2-cryotherapy for high risk Barrett’s esophagus (BE) patients with high grade dysplasia and early adenocarcinoma: a pilot trial of feasibility and safety. Gastrointest Endosc67: AB179-80.
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Chennat, J.S., Konda, V.J., Ross, A.S., Herreros de Tejada, A., Cislo, B.M., Stearns, L. et al. (2008a) Correlation of Barrett’s histological surveillance biopsies versus final endoscopic mucosectomy resection (EMR) specimens: are we seeing the forest or just the trees?Gastrointest Endosc67: AB171-2.
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Chennat, J.S., Konda, V.J., Ross, A.S., Herreros de Tejada, A., Cislo, B.M., Stearns, L. et al. (2008b) Safety profile of single session complete Barrett’s esophagus endoscopic mucosal resection (CBD-EMR). Gastrointest Endosc67: AB172.
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Deprez, P.H., Yeung, R.C., Aouattah, T., Sempoux, C. and Piessevaux, H. ( 2008) Prospective randomized comparison between EMR and ESD for endoscopic removal of superficial esophageal cancer. Gastrointest Endosc67: AB187.
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Dumot, J.A., Vargo, J.J., Zuccaro, G., Falk, G.W., Frey, L. and Rice, T. ( 2008) Results of cryospray ablation for esophageal high grade dysplasia (HGD) and intramucosal cancer (IMCA) in high risk non-surgical patients . Gastrointest Endosc67: AB176.
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Finkelstein, S.D. and Lyday, W.D. ( 2008) The molecular pathology of radiofrequency mucosal ablation of Barrett’s esophagus. Gastroenterology134(Suppl. 1): A436-.
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Fukami, N., Dekovich, A.A., Sericati, M.R., Maru, D., Wang, H. and Hofstetter, W.L. ( 2008) Multifocal high-grade dysplasia (MFHGD) in Barrett’s esophagus is associated with adenocarcinoma in patients undergoing endoscopic mucosal resection (EMR) for Barrett’s esophagus. Gastrointest Endosc67: AB180.
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Gondrie, J.J., Seewald, S., Pouw, R.E., Piessavaux, H., Deprez, P.H., Pohl, H. et al. (2008) Stepwise radical endoscopic resection for complete removal of Barrett’s esophagus with early neoplasia: an international multicenter study. Gastrointest Endosc67: AB175-6.
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Greenwald, B.D., Horwhat, J.D., Abrams, J.A., Lightdale, C.J. and Dumot, J.A. ( 2008) Endoscopic cryotherapy ablation is safe and well-tolerated in Barrett’s esophagus, esophageal dysplasia and esophageal cancer. Gastrointest Endosc67: AB76.
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Gross, S.A., Gill, K.R., Greenwald, B.D. and Wolfsen, H.C. ( 2008) Burn, freeze or photo-ablate? Comparative symptom profile in patients with Barrett’s high grade dysplasia undergoing endoscopic ablation. Gastrointest Endosc67: AB180-1.
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Hernandez, J.C., Chung, D.S., Pham, B.V., Reicher, S., Tsai, F., Chahal-Sekhon, N. et al. (2008) Interim analysis of Barrett’s esophagus eradication by radiofrequency ablation. Gastrointest Endosc67: AB180.
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Ishii, N., Tsukamoto, M., Izuka, Y., Fukuda, K., Yamazaki, K., Kumakura, Y. et al. (2008) Endoscopic submucosal dissection is a safe and effective treatment for superficial esophageal cancer. First results in a primary hospital. Gastrointest Endosc67: AB184.
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Lightdale, C.J., Overholt, B.F., Wang, K.K., Mashimo, H., Sharma, V.K., Fleischer, D.E. et al. (2008) Predictors of quantitative assessment of incomplete response after radiofrequency ablation for dysplastic Barrett’s esophagus: analysis of randomized sham-controlled clinical trial (the AIM Dysplasia trial) . Gastrointest Endosc67: AB182.
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Manner, H., May, A., Pech, O., Gossner, L., Rabenstein, T., Vieth, M. et al. (2008) Are patients with ‘low risk’ submucosal invasion of early Barrett’s carcinoma eligible for curative endoscopic therapy? Outcomes of endoscopic therapy and surgery in 80 patients with suspected or definite diagnosis of submucosal Barrett’s cancer. Gastrointest Endosc67: AB75-6.
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