TY - JOUR
T1 - Endoscopic Therapy of Dysplasia and Early-Stage Cancers of the Esophagus
AU - Tokar, Jeffrey L.
AU - Haluszka, Oleh
AU - Weinberg, David S.
PY - 2007/1
Y1 - 2007/1
N2 - Endoscopic treatments have become a viable alternative for some patients with early-stage esophageal neoplasia. Although esophagectomy remains the standard of care for high-grade dysplasia and superficial cancers, surgical morbidity and mortality may deter patients who are medically unfit or reluctant to undergo surgery. Photodynamic therapy (PDT) and endoscopic mucosal resection (EMR) are the best-studied nonsurgical approaches at present. PDT has been reported to eradicate high-grade dysplasia (HGD) and early Barrett's cancers at rates ranging from 75% to 100% and 17% to 100%, respectively, and a recent randomized controlled trial confirmed that PDT may prevent progression of HGD to cancer. Complete remission rates greater than 90% have also been reported with EMR and other mucosa-ablating interventions, although recurrence rates necessitate close endoscopic surveillance and retreatment in some patients. In addition to PDT and EMR, several emerging endoscopic treatment options for superficial esophageal neoplasia may provide attractive alternatives to surgery.
AB - Endoscopic treatments have become a viable alternative for some patients with early-stage esophageal neoplasia. Although esophagectomy remains the standard of care for high-grade dysplasia and superficial cancers, surgical morbidity and mortality may deter patients who are medically unfit or reluctant to undergo surgery. Photodynamic therapy (PDT) and endoscopic mucosal resection (EMR) are the best-studied nonsurgical approaches at present. PDT has been reported to eradicate high-grade dysplasia (HGD) and early Barrett's cancers at rates ranging from 75% to 100% and 17% to 100%, respectively, and a recent randomized controlled trial confirmed that PDT may prevent progression of HGD to cancer. Complete remission rates greater than 90% have also been reported with EMR and other mucosa-ablating interventions, although recurrence rates necessitate close endoscopic surveillance and retreatment in some patients. In addition to PDT and EMR, several emerging endoscopic treatment options for superficial esophageal neoplasia may provide attractive alternatives to surgery.
KW - Barrett's esophagus
KW - endoscopic ablation
KW - endoscopic mucosal resection
KW - endoscopic therapy
KW - esophageal cancer
KW - high-grade dysplasia
KW - photodynamic therapy
UR - http://www.scopus.com/inward/record.url?scp=33845505886&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000245998400003&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.semradonc.2006.09.004
DO - 10.1016/j.semradonc.2006.09.004
M3 - Article
C2 - 17185193
SN - 1053-4296
VL - 17
SP - 10
EP - 21
JO - Seminars in Radiation Oncology
JF - Seminars in Radiation Oncology
IS - 1
ER -