Ablative Therapy for BE, Squamous Overgrowth, and Hidden Dysplasia

Recent findings indicate that the risk for squamous overgrowth hiding residual dysplasia following ablative therapy is low.

The literature supports the effectiveness of ablative therapy for Barrett esophagus with high-grade dysplasia (HGD) or early mucosal adenocarcinoma (JW Gastroenterol Sep 26 2008). However, a major concern with ablative therapy is neosquamous overgrowth of residual Barrett epithelium, which might hide subsquamous dysplasia or early neoplasia.

In this international, multicenter, 5-year study, researchers evaluated squamous overgrowth in 208 patients with BE and confirmed HGD who were randomized to photodynamic therapy with porfimer sodium plus omeprazole (PHOPDT) or omeprazole alone (20 mg/day; the control group). Patients had baseline pretreatment four-quadrant biopsy samples taken every 2 cm of the BE. Participants underwent endoscopy every …

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors