Abstract
Barrett’s esophagus (BE) is a well-established premalignant condition for the development of esophageal adenocarcinoma, a highly lethal cancer with a dismal 5-year overall survival rate. Histologic classification of dysplasia on endoscopic biopsies is the single most predictive biomarker for progression to cancer. Aggressive therapies for the treatment of low-grade dysplasia cannot be recommended, given its low risk of cancer progression and transient nature. Strategies proposed for the management of high-grade dysplasia include esophagectomy, intensive surveillance, and endoscopic therapies. Endoscopic mucosal resection is being used increasingly as a diagnostic and staging tool and as a treatment option in patients with high-grade dysplasia or mucosal adenocarcinoma. Of the ablative therapies, photodynamic therapy has the most extensive reported experience. Preliminary results of new ablative therapies such as radiofrequency ablation and cryoablation are promising. Future research should focus on long-term follow-up after endoscopic treatment and on the identification of high-risk groups using biomarkers and novel endoscopic tools.
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