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Endoscopic treatment of high-grade dysplasia and early stage cancer in Barrett's esophagus
Abstract
Background The aim of this study was to prospectively evaluate endoscopic resection (ER) combined with photodynamic therapy (PDT) for the treatment of selected patients with early neoplasia in Barrett's esophagus. Methods Patients with Barrett's esophagus and neoplastic lesions <2 cm in diameter and no sign of submucosal infiltration, positive lymph nodes, or distant metastasis underwent diagnostic ER (cap technique). Patients with a T1sm tumor in the resection specimen were referred for surgery; those with a T1m or a less invasive tumor underwent additional endoscopic therapy (ER, PDT, and/or argon plasma coagulation [APC]), or they were followed. PDT was performed with 5-aminolevulinic acid and a light dose of 100 J/cm 2 at lambda = 632 nm. Results Thirty-three patients underwent diagnostic ER. Endoscopic treatment was not performed in 5 patients, who underwent surgery (4 T1sm; 1, patient preference). Five patients were immediately entered into a follow-up protocol, and 23 received additional endoscopic treatment (13 additional ER, 19 PDT, 3 APC). Endoscopic treatment was successful in 26/28 patients; no severe complication was observed. During follow-up (median 19 months, range 13-24 months), 5/26 patients had a recurrence of high-grade dysplasia: all were successfully re-treated with ER. At the end of follow-up, 26/33 originally enrolled patients (79%) and 26/28 endoscopically treated patients (93%) were in local remission. Conclusions Endoscopic therapy is safe and effective for selected patients with early stage neoplasia in Barrett's esophagus.
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ALA-PDT was shown to be more effective in eradicating high-grade dysplasia than in treatment of early esophagus cancer.
“ALA-PDT was shown to be more effective in eradicating high-grade dysplasia than in treatment of early esophagus cancer [124,125].”
From Aminolevulinic Acid (ALA) as a Prodrug in Photodynamic Therapy of Cancer (2011) · cites this paper as [125]
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Metadata
- Authors
- Peters, F. P., Kara, M. A., Rosmolen, W. D., Aalders, M. C. G., ten Kate, F. J. W., Bultje, B. C., Krishnadath, K. K., Fockens, P., van Lanschot, J. J. B., van Deventer, S. J. H., & Bergman, J. J. G. H. M.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Bergman, Jacques J.G.H.M.
- ORCID
- Venue
- Gastrointestinal Endoscopy
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 61
- Issue
- 4
- Pages
- 506-514
- ISSN
- 0016-5107 (ISSN-L)
- OpenAlex
- W2062340807
- Cited by
- 172
- References
- 48
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 10 · 2015: 13 · 2014: 8 · 2013: 13 · 2012: 12
- FWCI
- 15.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastrointestinal Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Photodynamic Therapy Research Studies
- Keywords
- Barrett's esophagus, high-grade dysplasia, early esophageal cancer, endoscopic resection, photodynamic therapy, argon plasma coagulation, 5-aminolevulinic acid, recurrence, endoscopic treatment
- MeSH terms
- Aged, Argon, Barrett Esophagus, Esophageal Neoplasms, Esophagoscopy, Female, Humans, Male, Middle Aged, Neoplasm Staging, Photochemotherapy, Prospective Studies, Treatment Outcome, Laser Coagulation
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