Endoscopic therapy can be used in the treatment of high-grade intraepithelial neoplasia (HGIN) and mucosal adenocarcinoma (BC) in patients with Barrett's esophagus.
In this study, doctors from Germany present 5-year follow-up data from a large prospective study investigating the efficacy and safety of endoscopic treatment in these patients.
Dr Pech and colleagues included 61 patients with HGIN and 288 with BC in their study, between October 1996 and September 2002. Patients with submucosal or more advanced cancer were excluded.
Endoscopic resection was performed in 279 patients, photodynamic therapy in 55, and both procedures in 13. Two patients received argon plasma coagulation.
The doctors found that a complete response was achieved in 97% of patients.
They found that metachronous lesions developed in 22% of patients, and a total of 56 patients died of concomitant disease.
|Surgery was necessary in 4% after endoscopic therapy failed.|
The research team calculated the 5-year survival rate at 84%.
They also identified the risk factors most frequently associated with recurrence. These included piecemeal resection, long-segment Barrett's esophagus, no ablative therapy after complete response, more than 10 months until complete response, and multifocal neoplasia.
Dr Pech's team concluded, "This study showed that endoscopic therapy was highly effective and safe, with an excellent long-term survival rate".
"The risk factors identified may help stratify patients who are at risk for recurrence and those requiring more intensified follow-up".