Endoscopic Therapy of Dysplasia and Early-Stage Cancers of the Esophagus

Jeffrey L. Tokar, Oleh Haluszka, David S. Weinberg

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)10-21
Number of pages12
JournalSeminars in Radiation Oncology
Volume17
Issue number1
DOIs
StatePublished - Jan 2007

Keywords

  • Barrett's esophagus
  • endoscopic ablation
  • endoscopic mucosal resection
  • endoscopic therapy
  • esophageal cancer
  • high-grade dysplasia
  • photodynamic therapy

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