SRER effective treatment for early neoplasia in BE patients
MedWire News: Study results show that stepwise radical endoscopic resection (SRER) is an effective technique for complete removal of all neoplasia and Barrett’s esophagus (BE) mucosa.
Writing in the journal Gut, Jacques Bergman (University of Amsterdam, The Netherlands) and colleagues report that complete eradication of all neoplasia and intestinal metaplasia by the end of treatment occurred in 97.6% and 85.2% of patients, respectively, with corresponding values of 95.3% and 80.5% for sustained eradication at 32 months follow-up.
Bergman and team recruited 169 patients (151 men) with median BE of 3 cm and early neoplasia of 5 cm or less, without deep mucosal infiltration or lymph node metastases, who were treated by SRER from January 2000 to September 2006.
The intervention involved endoscopic resection every 4–8 weeks (2–3 sessions in total, 2–6 resections per session), until complete endoscopic and histological eradication of all neoplasia and intestinal metaplasia was achieved.
Overall, just 1.2% of patients had acute or severe complications from the treatment, which were all perforations. Symptomatic stenoses developed in 49.7% of patients. One patient had a progression of neoplasia during treatment and later died from metastasized adenocarcinoma.
“Neoplasia recurrence after complete eradication of the Barrett’s segment was rare during a follow-up of 32 months, which shows that all Barrett’s mucosa should be removed for a persistent treatment effect,” say the authors.
“However, the high rate of esophageal stenosis in almost half of the patients is a significant drawback of this approach that needs to be overcome by developments to prevent post-ER structuring,” they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Helen Albert