Endoscopic Therapy Is Highly Successful for Early Barrett’s Cancer
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Endoscopic Therapy Is Highly Successful for Early Barrett’s Cancer

Prateek Sharma, MD, FASGE, reviewing Kahn A, et al. Gastrointest Endosc 2023 Jun 23.

For patients with intramucosal esophageal adenocarcinoma (T1a EAC), endoscopic treatment (endoscopic resection, followed by ablation) is the current standard.

This study focused on patients with T1 EAC who underwent successful endoscopic cancer therapy with at least 5 years of clinical follow-up. Among 84 patients (75 T1a, 9 T1b) with a median follow-up of 9.1 years, the overall incidence of neoplastic recurrence was 2.0 cases per 100 patient-years of follow-up. Sixteen patients (19%) experienced neoplastic recurrence (7 low-grade dysplasia, 1 high-grade dysplasia, and 8 EAC), 7 of which occurred after 5 years (3 dysplastic, 4 recurrent EAC) of EAC remission. Encouragingly, 88% of these recurrences were treated successfully with endoscopic treatment. However, EAC recurrence-related mortality was observed in 3 patients at a median of 5.2 years after EAC remission. Achievement of complete eradication of intestinal metaplasia was associated with reduced neoplastic recurrence (hazard ratio, 0.13).

Prateek Sharma, MD, FASGE

COMMENT

Long-term results of endoscopic therapy for early Barrett’s cancer (stage T1 EAC) are very promising, making it the first-line approach for these patients.

 

 

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Kahn A, Song K, Dhaliwal L, et al. Long-term outcomes following successful endoscopic treatment of T1 esophageal adenocarcinoma: a multicenter cohort study. Gastrointest Endosc 2023 Jun 23. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2023.06.012)

 

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