Today’s Mistakes and Tomorrow’s Wisdom in Endoscopic Treatment and Follow-Up of Barrett’s Esophagus

Barret M.a,b

Author affiliations

aGastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
bFaculté de Médecine, Université de Paris, Paris, France

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Article / Publication Details

First-Page Preview

Abstract of Review Article

Received: October 11, 2021
Accepted: February 08, 2022
Published online: March 18, 2022

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 1

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

Abstract

Background: Endoscopic therapy has replaced esophagectomy for the management of early Barrett’s neoplasia, allowing for the curative treatment of intramucosal adenocarcinoma, dysplastic Barrett’s esophagus (BE), and the prevention of metachronous recurrences. Summary: Endoscopic therapy relies on the resection of any visible lesion, suspicious of harboring cancer, followed by the eradication of the residual BE, potentially harboring dysplastic foci. Currently, endoscopic mucosal resection (EMR) using the multiband mucosectomy technique is the gold standard for the resection of visible lesions. Endoscopic submucosal dissection (ESD) is feasible with comparable complication rates to EMR, but longer procedural times. It is still limited to EMR failures or suspected submucosal adenocarcinoma. Eradication of residual BE mainly relies on radiofrequency ablation, with over 90% efficacy in expert centers. Despite initial complete eradication of BE, intestinal metaplasia and dysplasia recur in time, justifying prolonged endoscopic surveillance. Key Messages: The first step of the therapeutic endoscopy for BE is a careful diagnostic evaluation, searching for visible(s) lesion(s). EMR is the recommended resection technique for visible lesions. ESD has not demonstrated its superiority on EMR in routine practice. Endoscopic follow-up after Barrett’s eradication therapy is mandatory.

© 2022 S. Karger AG, Basel

References Sharma P, Shaheen NJ, Katzka D, Bergman JJGHM. Clinical practice update: endoscopic treatment of Barrett’s esophagus with dysplasia and/or early cancer. Gastroenterology. 2020 Feb;158(3):760–9. Barret M, Pioche M, Terris B, Ponchon T, Cholet F, Zerbib F, et al. Endoscopic radiofrequency ablation or surveillance in patients with Barrett’s oesophagus with confirmed low-grade dysplasia: a multicentre randomised trial. Gut. 2021;70:1014–22. Weusten B, Bisschops R, Coron E, Dinis-Ribeiro M, Dumonceau JM, Esteban JM, et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2017;49:191–8. Wani S, Abrams J, Edmundowicz SA, Gaddam S, Hovis CE, Green D, et al. Endoscopic mucosal resection results in change of histologic diagnosis in Barrett’s esophagus patients with visible and flat neoplasia: a multicenter cohort study. Dig Dis Sci. 2013;58:1703–9. Podboy A, Kolahi KS, Friedland S, Louie CY. Endoscopic submucosal dissection is associated with less pathologic uncertainty than endoscopic mucosal resection in diagnosing and staging Barrett’s-related neoplasia. Dig Endosc. 2020;32:346–54. Pech O, Behrens A, May A, Nachbar L, Gossner L, Rabenstein T, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57:1200–6. van Vilsteren FGI, Pouw RE, Seewald S, Alvarez Herrero L, Sondermeijer CM, Visser M, et al. Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett’s oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial. Gut. 2011;60:765–73. Orman ES, Li N, Shaheen NJ. Efficacy and durability of radiofrequency ablation for Barrett’s esophagus: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11:1245–55. van Munster S, Nieuwenhuis E, Weusten BLAM, Alvarez Herrero L, Bogte A, Alkhalaf A, et al. Long-term outcomes after endoscopic treatment for Barrett’s neoplasia with radiofrequency ablation ± endoscopic resection: results from the national Dutch database in a 10-year period. Gut. 2022 Feb;71(2):265–76. Pouw RE, van Vilsteren FGI, Peters FP, Alvarez Herrero L, Ten Kate FJ, Visser M, et al. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett’s neoplasia. Gastrointest Endosc. 2011;74:35–43. Alvarez Herrero L, Pouw RE, van Vilsteren FGI, ten Kate FJ, Visser M, Seldenrijk CA, et al. Safety and efficacy of multiband mucosectomy in 1,060 resections in Barrett’s esophagus. Endoscopy. 2011;43:177–83. Pouw RE, Beyna T, Belghazi K, Koch AD, Schoon EJ, Haidry R, et al. A prospective multicenter study using a new multiband mucosectomy device for endoscopic resection of early neoplasia in Barrett’s esophagus. Gastrointest Endosc. 2018;88:647–54. Belghazi K, van Vilsteren FGI, Weusten BLAM, Meijer SL, Bergman JJGHM, Pouw RE, et al. Long-term follow-up results of stepwise radical endoscopic resection for Barrett’s esophagus with early neoplasia. Gastrointest Endosc. 2018;87:77–84. ASGE Standards of Practice Committee; Qumseya B, Sultan S, Bain P, Jamil L, Jacobson B, et al. ASGE guideline on screening and surveillance of Barrett’s esophagus. Gastrointest Endosc. 2019;90:335–59.e2. van Vilsteren FGI, Pouw RE, Alvarez Herrero L, Bisschops R, Houben M, Peters FT, et al. Learning endoscopic resection in the esophagus. Endoscopy. 2015;47:972–9. Chennat J, Konda VJA, Ross AS, de Tejada AH, Noffsinger A, Hart J, et al. Complete Barrett’s eradication endoscopic mucosal resection: an effective treatment modality for high-grade dysplasia and intramucosal carcinoma – an American single-center experience. Am J Gastroenterol. 2009;104:2684–92. Pouw RE, Seewald S, Gondrie JJ, Deprez PH, Piessevaux H, Pohl H, et al. Stepwise radical endoscopic resection for eradication of Barrett’s oesophagus with early neoplasia in a cohort of 169 patients. Gut. 2010;59:1169–77. Bartel MJ, Mousa OY, Brahmbhatt B, Coffman DL, Patel K, Repici A, et al. Impact of topical budesonide on prevention of esophageal stricture after mucosal resection. Gastrointest Endosc. 2021;93:1276–82. Barret M, Beye B, Leblanc S, Beuvon F, Chaussade S, Batteux F, et al. Systematic review: the prevention of oesophageal stricture after endoscopic resection. Aliment Pharmacol Ther. 2015;42:20–39. Barret M, Belghazi K, Weusten BLAM, Bergman JJ, Pouw RE. Single-session endoscopic resection and focal radiofrequency ablation for short-segment Barrett’s esophagus with early neoplasia. Gastrointest Endosc. 2016;84:29–36. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, Repici A, Vieth M, De Ceglie A, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47:829–54. Terheggen G, Horn EM, Vieth M, Gabbert H, Enderle M, Neugebauer A, et al. A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett’s neoplasia. Gut. 2017;66:783–93. Mejia Perez LK, Yang D, Draganov PV, Jawaid S, Chak A, Dumot J, et al. Endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett’s neoplasia in the West: a retrospective study. Endoscopy. 2021. Yang J, Novak S, Ujiki M, Hernández Ó, Desai P, Benias P, et al. An international study on the use of peroral endoscopic myotomy in the management of Zenker’s diverticulum. Gastrointest Endosc. 2020;91:163–8. Subramaniam S, Chedgy F, Longcroft-Wheaton G, Kandiah K, Maselli R, Seewald S, et al. Complex early Barrett’s neoplasia at 3 Western centers: European Barrett’s Endoscopic Submucosal Dissection Trial (E-BEST). Gastrointest Endosc. 2017;86:608–18. Manner H, Rabenstein T, Pech O, Braun K, May A, Pohl J, et al. Ablation of residual Barrett’s epithelium after endoscopic resection: a randomized long-term follow-up study of argon plasma coagulation vs. surveillance (APE study). Endoscopy. 2014;46:6–12. Manner H, May A, Kouti I, Pech O, Vieth M, Ell C, et al. Efficacy and safety of Hybrid-APC for the ablation of Barrett’s esophagus. Surg Endosc. 2016;30:1364–70. Knabe M, Beyna T, Rösch T, Bergman J, Manner H, May A, et al. Hybrid APC in combination with resection for the endoscopic treatment of neoplastic Barrett’s esophagus: a prospective, multicenter study. Am J Gastroenterol. 2022;117:110–9. Qumseya BJ, Wani S, Desai M, Qumseya A, Bain P, Sharma P, et al. Adverse events after radiofrequency ablation in patients with Barrett’s esophagus: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14:1086–95.e6. Sami SS, Ravindran A, Kahn A, Snyder D, Santiago J, Ortiz-Fernandez-Sordo J, et al. Timeline and location of recurrence following successful ablation in Barrett’s oesophagus: an international multicentre study. Gut. 2019;68:1379–85. Fasullo M, Shah T, Patel M, Mutha P, Zfass A, Lippman R, et al. Outcomes of radiofrequency ablation compared to liquid nitrogen spray cryotherapy for the eradication of dysplasia in Barrett’s esophagus. Dig Dis Sci. 2021. Canto MI, Shaheen NJ, Almario JA, Voltaggio L, Montgomery E, Lightdale CJ. Multifocal nitrous oxide cryoballoon ablation with or without EMR for treatment of neoplastic Barrett’s esophagus (with video). Gastrointest Endosc. 2018;88:438–46.e2. van Munster SN, Overwater A, Raicu MGM, Seldenrijk KCA, Nagengast WB, Schoon EJ, et al. A novel cryoballoon ablation system for eradication of dysplastic Barrett’s esophagus: a first-in-human feasibility study. Endoscopy. 2020;52:193–201. Komanduri S, Kahrilas PJ, Krishnan K, McGorisk T, Bidari K, Grande D, et al. Recurrence of Barrett’s esophagus is rare following endoscopic eradication therapy coupled with effective reflux control. Am J Gastroenterol. 2017;112:556–66. Peerally MF, Bhandari P, Ragunath K, Barr H, Stokes C, Haidry R, et al. Radiofrequency ablation compared with argon plasma coagulation after endoscopic resection of high-grade dysplasia or stage T1 adenocarcinoma in Barrett’s esophagus: a randomized pilot study (BRIDE). Gastrointest Endosc. 2019;89:680–9. Haidry RJ, Lipman G, Banks MR, Butt MA, Sehgal V, Graham D, et al. Comparing outcome of radiofrequency ablation in Barrett’s with high grade dysplasia and intramucosal carcinoma: a prospective multicenter UK registry. Endoscopy. 2015;47:980–7. van Munster SN, Frederiks CN, Nieuwenhuis EA, Offerhaus JGJA, Meijer SL, Brosens LAA, et al. Incidence and outcomes of poor healing and poor squamous regeneration after radiofrequency ablation therapy for early Barrett’s neoplasia. Endoscopy. 2021. Guthikonda A, Cotton CC, Madanick RD, Spacek MB, Moist SE, Ferrell K, et al. Clinical outcomes following recurrence of intestinal metaplasia after successful treatment of Barrett’s esophagus with radiofrequency ablation. Am J Gastroenterol. 2017;112:87–94. Cotton CC, Wolf WA, Overholt BF, Li N, Lightdale CJ, Wolfsen HC, et al. Late recurrence of Barrett’s esophagus after complete eradication of intestinal metaplasia is rare: final report from ablation in intestinal metaplasia containing dysplasia trial. Gastroenterology. 2017;153:681–8.e2. Phoa KN, Pouw RE, Bisschops R, Pech O, Ragunath K, Weusten BL, et al. Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut. 2016;65:555–62. Morales TG, Camargo E, Bhattacharyya A, Sampliner RE. Long-term follow-up of intestinal metaplasia of the gastric cardia. Am J Gastroenterol. 2000;95:1677–80. Article / Publication Details

First-Page Preview

Abstract of Review Article

Received: October 11, 2021
Accepted: February 08, 2022
Published online: March 18, 2022

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 1

ISSN: 2297-4725 (Print)
eISSN: 2297-475X (Online)

For additional information: https://www.karger.com/VIS

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