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 24 May 2018

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News

Endoscopic resection specimens from Barrett's esophagus and neoplasia

Early Barrett's neoplasms removed by endoscopic resection are mostly limited to the mucosa, find researchers in the September issue of Endoscopy.

News image

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Endoscopic resection has been recommended as a local curative approach for Barrett’s neoplasia.

In this study, researchers from Germany analyzed the histological characteristics of endoscopic resection specimens of Barrett’s neoplasia.

They assessed 742 endoscopic resection specimens from 326 patients.

The team examined the type of neoplasia, grade of differentiation, depth of infiltration, invasion into lymphatic and blood vessels, and resection status.

They found that 31 patients had no neoplasia, and these were excluded from the analysis.
R0 status was achieved in 75 % of patients.
Endoscopy

In the remaining 295 patients, the team found low-grade intraepithelial neoplasia (1%), high-grade intraepithelial neoplasia (3%), and mucosal carcinoma (80%).

They determined that carcinomas infiltrating the submucosal layer were rare. Carcinomas invading lymph vessels were also rare.

Most carcinomas were well-differentiated (72.2 %), and most were limited to the mucosa.

The researchers found that R0 status was achieved in 75 % of patients.

Dr Vieth and colleagues concluded, "Our study demonstrates that early Barrett’s neoplasms removed by endoscopic resection are mostly limited to the mucosa, are well to moderately differentiated, and very rarely show invasion of the lymph or blood vessels".

"Although these lesions seem to be low risk with regard to metastatic spread and therefore treatable endoscopically, improved endoscopic resection methods for achieving one-piece (en bloc) R0 resection should be developed".

Endoscopy 2004; 36(9): 776-81
26 August 2004

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