New endoscopic treatment may spare Barrett's esophagus patients from surgery

Feb 18, 2010

Early tumor formation in Barrett's esophagus (BE) can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

"Barrett's esophagus is the most important risk factor for the development of esophageal cancer, but there is no generally accepted management strategy for patients with early neoplasia in Barrett's esophagus," said Jacques J.G. H. M. Bergman, MD, of the Academic Medical Center and lead author of the study. "Combining endoscopic resection with complete removal of residual Barrett cells with radiofrequency ablation may decrease the recurrence of lesion formation and could potentially limit the number of Barrett's esophagus cases that progress to esophageal cancer."

In this European multi-center, prospective cohort study, doctors evaluated the safety and efficacy of this combined modality approach in 23 BE patients with high-grade intraepithelial neoplasia (seven patients) or early cancer (16 patients). Eradication of tumors and abnormal was achieved in 95 percent and 88 percent of patients, and after additional escape endoscopic resection in two patients, in 100 percent and 96 percent of patients, respectively. Complications after RFA included melena (dark tarry stool) and difficulty swallowing. After additional follow-up, no neoplasia recurred.

"Selection of Barrett's esophagus patients for endoscopic treatment involves thorough endoscopic work-up, the possibility to safely perform endoscopic resection and accurate histological evaluation of tissue specimens for the presence of risk factors for disease spread," added Dr. Bergman. "Patients in our study received care in highly specialized centers, making it difficult to extrapolate the high reported safety and effectives to all medical centers. We believe the use of radiofrequency ablation for Barrett's should be centralized in multi-disciplinary centers with this expertise."

Currently, the cornerstone of treatment of early BE tumors is endoscopic resection in which visible lesions are removed, and tumor infiltration depth and differentiation are assessed. After focal endoscopic resection, however, the residual Barrett mucosa remains at risk for malignant transformation and cancer recurrences are found in 30 percent of patients during follow-up. To prevent such lesions, endoscopic approaches have been studied in an attempt to eradicate the residual Barrett mucosa. The newer endoscopic ablation technique, RFA, has promising safety and efficacy results.

Explore further: Pepper and halt: Spicy chemical may inhibit gut tumors

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Pepper and halt: Spicy chemical may inhibit gut tumors

4 hours ago

Researchers at the University of California, San Diego School of Medicine report that dietary capsaicin – the active ingredient in chili peppers – produces chronic activation of a receptor on cells lining ...

Expressive writing may help breast cancer survivors

5 hours ago

Writing down fears, emotions and the benefits of a cancer diagnosis may improve health outcomes for Asian-American breast cancer survivors, according to a study conducted by a researcher at the University of Houston (UH).

Taking the guesswork out of cancer therapy

11 hours ago

Researchers and doctors at the Institute of Bioengineering and Nanotechnology (IBN), Singapore General Hospital (SGH) and National Cancer Centre Singapore (NCCS) have co-developed the first molecular test ...

Brain tumour cells found circulating in blood

12 hours ago

(Medical Xpress)—German scientists have discovered rogue brain tumour cells in patient blood samples, challenging the idea that this type of cancer doesn't generally spread beyond the brain.

International charge on new radiation treatment for cancer

13 hours ago

(Medical Xpress)—Imagine a targeted radiation therapy for cancer that could pinpoint and blast away tumors more effectively than traditional methods, with fewer side effects and less damage to surrounding tissues and organs.

User comments : 0