High-grade dysplasia within Barrett's esophagus: controversies regarding clinical opinions and approaches

Annals of Surgical Oncology
Mazin F Al-KasspoolesJohn F Gibbs

Abstract

Barrett's esophagus with high-grade dysplasia is a well-known risk factor for the development of esophageal adenocarcinoma, which has become the predominant form of esophageal cancer in the United States. This review addresses four major fundamental issues that shape our treatment decisions regarding high-grade dysplasia within Barrett's esophagus: (1) the poorly defined natural history of high-grade dysplasia in its progression to adenocarcinoma, (2) the potentially high morbidity and mortality of esophageal resection for high-grade dysplasia, (3) the difficulty in detecting cancer among dysplastic cells during endoscopy, and (4) the controversial role of endoscopic mucosal ablative therapy for high-grade dysplasia. Until there are more accurate surveillance methods, better biochemical or molecular markers in predicting cancerous progression, or more effective minimally invasive methods of treatment, esophagogastrectomy must be considered the standard means of managing patients with Barrett's esophagus and high-grade dysplasia. Regular rigorous systematic surveillance and endoscopic mucosal ablation are alternative treatment options that are available but should be used only under strict conditions. The decision to proceed in ...Continue Reading

References

Apr 1, 1979·Cancer·A BoschW L Caldwell
Jul 1, 1978·The British Journal of Surgery·J N Webb, A Busuttil
Jul 1, 1978·American Journal of Clinical Pathology·R C HaggittH Colcher
May 1, 1992·Human Pathology·J E McArdleW Weinstein
Aug 1, 1992·The Annals of Thoracic Surgery·M PeraP C Pairolero
Jan 1, 1991·American Journal of Surgery·N K AltorkiD B Skinner
Dec 1, 1985·The American Journal of Surgical Pathology·R G Lee
May 1, 1989·Gastroenterology·W HameetemanJ G van den Tweel
Sep 1, 1987·Cancer·W C MacDonald, J B MacDonald
Mar 1, 1987·American Journal of Clinical Pathology·S R Hamilton, R R Smith
Nov 1, 1968·Cancer·A D Turnbull, J T Goodner
Jun 1, 1994·Archives of Surgery·G W ClarkT R DeMeester
Oct 1, 1993·The British Journal of Surgery·J Rahamim, C W Cham
Feb 1, 1994·The Annals of Thoracic Surgery·J B PutnamJ A Roth
Dec 3, 1998·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M G PattiL W Way
Dec 8, 1998·JAMA : the Journal of the American Medical Association·C B BeggM F Brennan
Dec 31, 1998·Gastrointestinal Endoscopy·B F OverholtJ M Haydek
Mar 19, 1999·Endoscopy·H InoueT Iwai
Jul 10, 1999·Annals of Surgery·J WebberD Fromm
Nov 30, 2000·The American Journal of Gastroenterology·B J ReidD S Levine
May 1, 1955·A.M.A. Archives of Surgery·C B PUESTOWV L GUYNN

❮ Previous
Next ❯

Citations

Mar 14, 2014·Expert Review of Anticancer Therapy·Andrew CowieTimothy Underwood
Mar 12, 2009·Expert Review of Anticancer Therapy·Jennifer D McAllasterMazin Al-Kasspooles
Feb 14, 2008·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A D SavoyM B Wallace
Sep 21, 2006·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A K ShahK R DeVault
Apr 27, 2011·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·S J DebC Deschamps
Jun 16, 2010·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·A SánchezD Callejo
Jan 24, 2006·Seminars in Thoracic and Cardiovascular Surgery·Arjun PennathurJames D Luketich
Mar 7, 2006·Annales de chirurgie·J-P Triboulet
Mar 30, 2002·Annals of Surgical Oncology·Jeffrey H Peters

❮ Previous
Next ❯

Related Concepts

Related Feeds

Barrett Esophagus

Barrett’s esophagus if a serious complication of gastroesophageal reflux disease during which the normal esophageal lining changes to tissue that resembles intestinal lining. Here is the latest research.