There is an increasing incidence of adenocarcinoma in Barrett's esophagus.
Mortality and morbidity rates associated with surgical therapy for this condition are high.
Safe and effective but less invasive methods of treatment are needed.
Dr Christian Ell and colleagues from Germany evaluated efficacy and safety of endoscopic resection in these patients.
The research team designed a single-center prospective study, conducted between 1996 and 2003.
The team assessed a total of 100 consecutive patients with a mean age of 62 years with low-risk adenocarcinoma of the esophagus arising in Barrett's metaplasia.
The team used endoscopic resection with the suck-and-cut technique.
|Local remission was achieved in 99 of the 100 patients|
The researchers' main outcome measurements included complete local remission.
A total of 144 resections were performed without technical problems.
The team observed no major complications, and only 11 minor ones occurred.
The team noted that complete local remission was achieved in 99 of the 100 patients after 2 months, and a maximum of 3 resections.
During a mean follow-up period of 37 months, recurrent or metachronous carcinomas were found in 11% of the patients.
However, the researchers found that successful repeat treatment with endoscopic resection was possible in all of these cases.
The calculated 5-year survival rate was 98%.
The research team reported that 2 patients died of other causes.
Dr Ell's team concludes, “Although this was a nonblinded, nonrandomized study, we showed that endoscopic resection is associated with favorable outcomes for low-risk patients with early esophageal adenocarcinoma.”