Treatment of Dysplasia in Barrett Esophagus
Aranda-Hernandez Javier, Cirocco Maria, Marcon Norman,
소속 상세정보
( Aranda-Hernandez Javier )
University of Toronto Faculty of Medicine St. Michael’s Hospital Department of Medicine Division of Gastroenterology
( Cirocco Maria )
University of Toronto Faculty of Medicine St. Michael’s Hospital Department of Medicine Division of Gastroenterology
( Marcon Norman )
University of Toronto Faculty of Medicine St. Michael’s Hospital Department of Medicine Division of Gastroenterology
KMID : 1038120140470010055
Abstract
Barrett esophagus is recognized as a risk factor for the development of dysplasia and adenocarcinoma of the esophagus. Cancer is usually diagnosed at an advanced stage with a 5-year survival rate of 15%. Most of these patients present de novo and are not part of a surveillance program. Endoscopic screening with improvement in recognition of early lesions may change this pattern. In the past, patients diagnosed with dysplasia and mucosal cancer were best managed by esophagectomy. Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy. This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists’ interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis. The role of endoscopic therapy for superficial submucosal disease continues to be a challenge.
키워드
Barrett esophagus;Therapeutics;Dysplasia;Endoscopy;Endoscopic treatment
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