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Barrett and treatment high grade dysplasia

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https://www.readbyqxmd.com/read/28122386/endoscopic-management-of-barrett-s-esophagus-european-society-of-gastrointestinal-endoscopy-esge-position-statement
#1
Bas Weusten, Raf Bisschops, Emanuel Coron, Mário Dinis-Ribeiro, Jean-Marc Dumonceau, José-Miguel Esteban, Cesare Hassan, Oliver Pech, Alessandro Repici, Jacques Bergman, Massimiliano di Pietro
Current practices for the management of Barrett's esophagus (BE) vary across Europe, as several national European guidelines exist. This Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) is an attempt to homogenize recommendations and, hence, patient management according to the best scientific evidence and other considerations (e.g. health policy). A Working Group developed consensus statements, using the existing national guidelines as a starting point and considering new evidence in the literature...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#2
Sébastien Godat, Fabrice Caillol, Aurélie Autret, Erwan Bories, Christian Pesenti, Jean Philippe Ratone, Chiara De Cassan, Flora Poizat, Marc Giovannini
BACKGROUND: Endotherapy in cases of neoplastic Barrett esophagus (BE) relapse after successful initial endoscopic management is commonly accepted, but few studies analyze this topic and also take into account the metachronous lesions. AIMS: To evaluate the efficiency of endotherapy in the case of neoplastic BE relapse after successful complete endoscopic eradication of neoplastic BE and metaplastic BE. METHODS: Retrospective review of medical records was collected in a computerized and prospective manner between 2000 and 2015, in a single tertiary care center...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28072858/proton-pump-inhibitors-do-not-reduce-the-risk-of-esophageal-adenocarcinoma-in-patients-with-barrett-s-esophagus-a-systematic-review-and-meta-analysis
#3
Qiang Hu, Tian-Tian Sun, Jie Hong, Jing-Yuan Fang, Hua Xiong, Stephen J Meltzer
OBJECTIVES: Proton pump inhibitors (PPIs) have been used for treatment of Barrett's esophagus (BE) for many years. However, the connection between PPIs and esophageal adenocarcinoma (EAC) in patients with BE has still been controversial. The current systematic review and meta-analysis was designed to evaluate the association between PPIs and the risk of EAC or high-grade dysplasia (HGD) in patients with BE. METHODS: A systematic literature search of studies reporting the association between PPIs and the risk of EAC and/or HGD in patients with BE was conducted in PubMed, Embase, Web of Science and the Cochrane Library...
2017: PloS One
https://www.readbyqxmd.com/read/27997963/efficacy-of-the-cryoballoon-focal-ablation-system-for-the-eradication-of-dysplastic-barrett-s-esophagus-islands
#4
Hannah T Künzli, Dirk W Schölvinck, Sybren L Meijer, Kees A Seldenrijk, Jacques G H M Bergman, Bas L A M Weusten
Background and study aim Cryoablation can be used for the treatment of Barrett's esophagus (BE). A recent dosimetry study, using the CryoBalloon Focal Ablation System (CryoBalloon), demonstrated that 10-second ablations result in complete eradication of BE. However, the efficacy of 10-second ablation in a larger cohort of patients has not been investigated, nor has the potential of precise targeting of specific areas. The aim of the study was to assess the efficacy and performance (i. e. targeting of BE islands) of a 10-second cryoablation using the CryoBalloon...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/27995191/non-radical-stepwise-complete-endoscopic-resection-of-barrett-s-epithelium-in-short-segment-barrett-s-esophagus-has-a-low-stricture-rate
#5
Andreas Koutsoumpas, Lai Mun Wang, Adam A Bailey, Richard Gillies, Robert Marshall, Michael Booth, Bruno Sgromo, Nick Maynard, Barbara Braden
Background and aims: Radical endoscopic excision of Barrett's epithelium performing 4 - 6 endoscopic resections during the same endoscopic session results in complete Barrett's eradication but has a high stricture rate (40 - 80 %). Therefore radiofrequency ablation is preferred after endoscopic mucosal resection (EMR) of visible nodules. We investigated the clinical outcome of non-radical, stepwise endoscopic mucosal resection with a maximum of two endoscopic resections per endoscopic session. Methods: We analysed our prospectively maintained database of patients undergoing esophageal EMR for early neoplasia in Barrett's esophagus from 2009 to 2014...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27984396/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#6
Bryan Brimhall, Sachin Wani
Barrett esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer associated with a poor 5-year survival rate. The stepwise pathologic progression of BE to invasive cancer provides an opportunity to halt progression and potentially decrease incidence and ultimately the morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) in patients at increased risk of progression to invasive EAC (intramucosal EAC, high-grade dysplasia, and low-grade dysplasia) is a practice that is endorsed by multiple societies and has replaced esophagectomy as the standard of care for these patients...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27971324/cost-effectiveness-of-endoscopic-treatment-with-radiofrequency-ablation-for-patients-with-barrett-s-esophagus-and-high-or-low-grade-dysplasia-in-spain
#7
J M Esteban, P González Carro, J Gornals, C Collados, M Álvarez, A Pérez-Mitru, S Serip
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27956164/the-cost-effectiveness-of-radiofrequency-ablation-for-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-randomized-controlled-trial-surf-trial
#8
K N Phoa, W D Rosmolen, B L A M Weusten, R Bisschops, E J Schoon, S Das, K Ragunath, G Fullarton, M DiPietro, N Ravi, J G P Tijssen, M G W Dijkgraaf, J J G H M Bergman
BACKGROUND & AIMS: The Surveillance versus RadioFrequency ablation (SURF)-trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n=68) or endoscopic surveillance (control, n=68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial...
December 9, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27941583/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#9
Bryan Brimhall, Sachin Wani
Barrett esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer associated with a poor 5-year survival rate. The stepwise pathologic progression of BE to invasive cancer provides an opportunity to halt progression and potentially decrease incidence and ultimately the morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) in patients at increased risk of progression to invasive EAC (intramucosal EAC, high-grade dysplasia, and low-grade dysplasia) is a practice that is endorsed by multiple societies and has replaced esophagectomy as the standard of care for these patients...
January 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27941559/expression-of-cas-cse1l-the-cellular-apoptosis-susceptibility-protein-correlates-with-neoplastic-progression-in-barrett-s-esophagus
#10
Kun Jiang, Kevin Neill, Daniel Cowden, Jason Klapman, Steven Eschrich, José Pimiento, Mokenge P Malafa, Domenico Coppola
BACKGROUND: Identifying the molecular switch responsible for the neoplastic progression of Barrett's esophagus (BE) and initiation of adenocarcinoma (ADC) is clinically essential and it will have a profound impact on patient diagnosis, prognosis, and treatment. The cellular apoptosis susceptibility gene CAS/CSE1L is overexpressed in various cancers, including a rare report on esophageal ADC; however, its expression in BE neoplasia has not been addressed. MATERIALS AND METHODS: We investigated the expression of the CAS/CSE1L protein immunohistochemically in 56 esophageal resection specimens for ADC arising in BE...
December 9, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/27889544/role-of-eus-in-patients-with-suspected-barrett-s-esophagus-with-high-grade-dysplasia-or-early-esophageal-adenocarcinoma-impact-on-endoscopic-therapy
#11
Michael J Bartel, Timothy M Wallace, Rene D Gomez-Esquivel, Massimo Raimondo, Herbert C Wolfsen, Timothy A Woodward, Michael B Wallace
BACKGROUND AND AIMS: Endoscopic therapy is the standard treatment for high-grade dysplasia and some cases of T1a esophageal adenocarcinoma (EAC), but it is not appropriate for deeply invasive disease. Data on the value of EUS for patient selection for endoscopic or surgical resection are conflicting. We investigated the outcome of esophageal EUS for the staging and treatment selection of patients with treatment-naive, premalignant Barrett's esophagus (BE) and suspected superficial EAC...
November 24, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#12
Dirk W Schölvinck, Kim van der Meulen, Jacques J G H M Bergman, Bas L A M Weusten
Background and aims Endoscopic treatment of Barrett's esophagus (BE) consists of endoscopic resection of visible lesions followed by radiofrequency ablation (RFA) for any remaining flat BE. Because RFA is only justified in flat BE, detection of neoplastic lesions (high grade dysplasia [HGD] and early adenocarcinoma [EAC]) is crucial. We hypothesized that the detection of visible lesions containing HGD or EAC would be superior in BE expert centers compared with community hospitals, thereby supporting centralization of therapy for BE-related neoplasia...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/27756772/silencer-of-death-domain-mediates-acid-induced-decrease-in-cell-apoptosis-in-barrett-s-associated-esophageal-adenocarcinoma-cells
#13
Dan Li, Jie Hong, Weibiao Cao
We have shown that NADPH oxidase (NOX)5-S may mediate the acid-induced decrease in cell apoptosis. However, mechanisms of NOX5-S-dependent decrease in cell apoptosis are not fully understood. In this study, we found that silencer-of-death domain (SODD) was significantly increased in esophageal adenocarcinoma (EA) tissues, EA cell lines FLO and OE33, and a dysplastic cell line CP-B. Strong SODD immunostaining was significantly higher in low-grade dysplasia (66.7%), high-grade dysplasia (81.2%), and EA (71.2%) than in Barrett's mucosa (10...
January 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27733908/oesophageal-biopsies-are-insufficient-to-predict-final-histology-after-endoscopic-resection-in-early-barrett-s-neoplasia
#14
E Werbrouck, G De Hertogh, X Sagaert, G Coremans, H Willekens, I Demedts, R Bisschops
BACKGROUND: Endoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett's neoplasia. Adequate staging is important to assure a good oncological outcome. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of pre-operative biopsies in patients who undergo ER for high-grade dysplasia (HGD) or early adenocarcinoma (EAC) in Barrett's oesophagus (BE) and the cardia. METHODS: Between November 2005-May 2012, 142 ERs performed in 137 patients were obtained...
October 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/27688205/endoscopic-submucosal-dissection-for-barrett-s-early-neoplasia-a-multicenter-study-in-the-united-states
#15
Dennis Yang, Roxana M Coman, Michel Kahaleh, Irving Waxman, Andrew Y Wang, Amrita Sethi, Ashish R Shah, Peter V Draganov
BACKGROUND AND AIMS: The role of endoscopic submucosal dissection (ESD) in Barrett's early neoplasia is not well defined, with most studies originating from Asia and Europe. We aimed to assess the efficacy, safety, and results of ESD in Barrett's esophagus (BE) with high-grade dysplasia (HGD) and early adenocarcinoma (EAC) across centers in the United States. METHODS: Multicenter retrospective analysis on 46 patients with BE who underwent ESD for BE-HGD or EAC, or both, between January 2010 and April 2015...
September 28, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27542425/the-role-of-esophagogastroduodenoscopy-surveillance-for-patients-with-barrett-esophagus
#16
REVIEW
Kerri Palamara
Approximately 10% to 15% of patients who experience chronic gastroesophageal reflux disease have Barrett esophagus, which is associated with an increased risk of esophageal adenocarcinoma. If symptoms persist after 8 weeks of adhering to treatment and lifestyle modifications, or if alarm symptoms develop, patients should be referred for screening upper endoscopy. Those with evidence of Barrett esophagus with dysplasia should be monitored in an endoscopic surveillance program, and those with high-grade dysplasia should consider surgical treatment...
September 2016: Medical Clinics of North America
https://www.readbyqxmd.com/read/27541732/endoscopic-treatment-of-high-grade-dysplasia-and-intramucosal-esophageal-adenocarcinoma
#17
Craig C Reed, Nicholas J Shaheen
The endoscopic management of Barrett's esophagus (BE) has changed with the emergence of novel endoscopic technologies and new data informing the care of dysplastic BE and early adenocarcinoma. These changes include an expanded use of endoscopic ablative therapy as well new recommendations for surveillance intervals. For most patients with BE and high-grade dysplasia (HGD), endoscopic ablative therapy is the preferred treatment strategy. Ablation has consistently been shown to be effective, with less morbidity compared with surgery...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27541368/esophagectomy-as-a-treatment-consideration-for-early-stage-esophageal-cancer-and-high-grade-dysplasia
#18
Patrick J McLaren, James P Dolan
In recent years, a number of endoluminal procedures such as endoscopic resection and thermal ablation have emerged as less invasive treatment options for early esophageal cancer. These therapies have demonstrated excellent oncologic outcomes for dysplasia as well as intramucosal cancers. However, few studies have directly compared long-term outcomes of endoscopic therapy versus traditional esophagectomy. Current esophagectomy techniques now deliver consistently good outcomes in the hands of experienced surgeons at high volume centers, and this option should be considered an important treatment consideration for early esophageal cancer...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27158198/post-ablation-surveillance-in-barrett-s-esophagus-a-review-of-the-literature
#19
REVIEW
Matthew W Stier, Vani J Konda, John Hart, Irving Waxman
Barrett's esophagus (BE) is a pre-malignant condition affecting up to 15% of patients with gastroesophageal reflux disease. Neoplastic Barrett's mucosa is defined as harboring high grade dysplasia or intra-mucosal cancer, and carries a high risk of progression to esophageal adenocarcinoma. The rising incidence of Barrett's lesions along with the high morbidity of surgical approaches has led to the development of numerous validated endoscopic techniques capable of eradicating neoplastic mucosa in a minimally invasive manner...
May 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27129553/neoplastic-barrett-s-oesophagus-and-long-term-follow-up-after-endoscopic-therapy-complete-histological-eradication-of-barrett-associated-with-high-grade-dysplasia-significantly-decreases-neoplasia-relapse
#20
Fabrice Caillol, Sebastien Godat, Aurelie Autret, Erwan Bories, Christian Pesenti, Jean Phillippe Ratone, Flora Poizat, Jerome Guiramand, Jean Robert Delpero, Marc Giovannini
BACKGROUND AND AIMS: Endotherapy (ET) has replaced surgery as the first-line treatment of high-grade dysplasia (HGD)/superficial ECA (ECAs) from Barrett's oesophagus (BO). However, long-term follow-up and predictive factors of relapse are not so well studied. The aim of the following study was to evaluate the efficiency of ET for treatment of HGD/ECAs and to determine factors of long-term efficiency. METHODS: ET procedures were manually reported and registered in a hospital data base from March 2000 to July 2010...
December 2016: Surgical Endoscopy
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