CC BY 4.0 · Endosc Int Open 2022; 10(10): E1331-E1332
DOI: 10.1055/a-1931-3841
Editorial

Follow-up after successful endoscopic therapy for early Barrett’s neoplasia: Is it time to talk money yet?

E. P.D. Verheij
1   Amsterdam UMC location University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
,
S. N. van Munster
1   Amsterdam UMC location University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
2   Sint Antonius Hospital, Gastroenterology and Hepatology, Nieuwegein, Netherlands
,
R. E. Pouw
1   Amsterdam UMC location University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, The Netherlands
› Author Affiliations

Endoscopic eradication therapy (EET) using endoscopic resection followed by radiofrequency ablation (RFA) has proven to be a safe and highly effective treatment for patients with Barrett’s-related neoplasia. Recently, long-term follow-up studies have reported a low risk for development of neoplastic recurrences in patients who were successfully treated and achieved complete eradication of dysplasia and intestinal metaplasia (CE-IM) [1] [2]. This has put a new light on the discussion regarding surveillance protocols after EET. Currently, these surveillance protocols are based on expert opinion and derive from the era when endoscopic resection was performed with surveillance of the remaining Barrett’s esophagus (BE) segment, instead of pursuing complete eradication of all BE using RFA. The quest for the optimal surveillance protocol after successful EET is ongoing, and with the recent long-term follow-up studies, current strategies will likely be subject to change.



Publication History

Article published online:
17 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 van Munster S, Nieuwenhuis E, Weusten B. et al. Long-term outcomes after endoscopic treatment for Barrettʼs neoplasia with radiofrequency ablation ± endoscopic resection: results from the national Dutch database in a 10-year period. Gut 2022; 71: 265-276
  • 2 Wolfson P, Ho KMA, Wilson A. et al. Endoscopic eradication therapy for Barrett’s esophagus–related neoplasia: a final 10-year report from the UK National HALO Radiofrequency Ablation Registry. Gastrointest Endosc 2022; 96: 223-233
  • 3 Menon S, Norman R, Mannath J. et al. Comparative cost effectiveness of three post radiofrequency ablation surveillance intervals for Barrett's oesophagus (BO). Endosc Int Open 2022; 10: E1053-E1064
  • 4 Shaheen NJ, Falk GW, Iyer PG. et al. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. Am J Gastroenterol 2016; 111: 30-50
  • 5 Cotton CC, Haidry R, Thrift AP. et al. Development of evidence-based surveillance intervals after radiofrequency ablation of Barrett's esophagus. Gastroenterology 2018; 155: 316-26.e6
  • 6 Fitzgerald RC, di Pietro M, Ragunath K. et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut 2014; 63: 7
  • 7 Sami SS, Ravindran A, Kahn A. et al. Timeline and location of recurrence following successful ablation in Barrett’s oesophagus: an international multicentre study. Gut 2019; 68: 1379
  • 8 van Munster S, Nieuwenhuis E, Bisschops R. et al. Dysplastic recurrence after successful treatment for early Barrettʼs neoplasia: development and validation of a prediction model. Gastroenterology 2022; 163: 285-294
  • 9 Wani S, Han S, Kushnir V. et al. Recurrence is rare following complete eradication of intestinal metaplasia in patients with Barrett’s esophagus and peaks at 18 months. Clin Gastroenterol Hepatol 2020; 18: 2609-17.e2
  • 10 Wolf WA, Pasricha S, Cotton C. et al. Incidence of esophageal adenocarcinoma and causes of mortality after radiofrequency ablation of Barrett’s esophagus. Gastroenterology 2015; 149: 1752-61.e1