Evolving management of metaplasia and dysplasia in Barrett’s epithelium

Oesophageal cancer affects more than 450000 people worldwide and despite continued medical advancements the incidence of oesophageal cancer is increasing. Oesophageal cancer has a 5 year survival of 15%-25% and now globally attempts are made to more aggressively diagnose and treat Barrett’s oesophag...

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Published inWorld journal of gastroenterology : WJG Vol. 22; no. 47; pp. 10316 - 10324
Main Authors Evans, Richard P T, Mourad, Moustafa Mabrouk, Fisher, Simon G, Bramhall, Simon R
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 21.12.2016
Subjects
Adenocarcinoma - diagnosis
Adenocarcinoma - epidemiology
Adenocarcinoma - surgery
Barrett Esophagus - diagnosis
Barrett Esophagus - epidemiology
Barrett Esophagus - therapy
Disease Progression
Esophageal Neoplasms - diagnosis
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - surgery
Esophagectomy - adverse effects
Esophagectomy - methods
Esophagoscopy - adverse effects
Esophagus - drug effects
Esophagus - pathology
Esophagus - surgery
Humans
Metaplasia
Minireviews
Predictive Value of Tests
Proton Pump Inhibitors - adverse effects
Proton Pump Inhibitors - therapeutic use
Risk Factors
Severity of Illness Index
Treatment Outcome
Watchful Waiting
Metaplasia
Oesophageal cancer
Dysplasia
Oesophagus
Barrett’s
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Summary:Oesophageal cancer affects more than 450000 people worldwide and despite continued medical advancements the incidence of oesophageal cancer is increasing. Oesophageal cancer has a 5 year survival of 15%-25% and now globally attempts are made to more aggressively diagnose and treat Barrett’s oesophagus the known precursor to invasive disease. Currently diagnosis the of Barrett’s oesophagus is predominantly made after endoscopic visualisation and histopathological confirmation. Minimally invasive techniques are being developed to improve the viability of screening programs. The management of Barrett’s oesophagus can vary greatly dependent on the presence and severity of dysplasia. There is no consensus between the major international medical societies to determine and agreed surveillance and intervention pathway. In this review we analysed the current literature to demonstrate the evolving management of metaplasia and dysplasia in Barrett’s epithelium.
Bibliography:Richard PT Evans;Moustafa Mabrouk Mourad;Simon G Fisher;Simon R Bramhall;Department of Surgery, the Wye Valley NHS Trust
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Telephone: +44-7976-278549 Fax: + 44-1432-364102
Correspondence to: Dr. Simon R Bramhall, Department of Surgery, the Wye Valley NHS Trust, Vaughan Building/Ruckhall La, Hereford HR1 2ER, United Kingdom. simon.bramhall@wvt.nhs.uk
Author contributions: Evans RPT designed the study; Evans RPT, Mourad MM and Fisher SG collected, analysed, interpreted the data, and drafted the article; Evans RPT and Bramhall SR designed the conception, critically revised the manuscript for important intellectual content, and made the final approval of the version to be published.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i47.10316