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Evolving Role of Endoscopic Submucosal Dissection in the Management of Barrett’s Neoplasia

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Abstract

Purpose of Review

We aim to examine evidence on endoscopic submucosal dissection (ESD) for managing Barrett’s esophagus related neoplasia by a narrative review.

Recent Findings

Available studies and meta-analysis indicate ESD has comparable efficacy rates and adverse events as to endoscopic mucosal resection for managing Barrett’s neoplasia. There is a high rate of en bloc, curative resections for T1a cancers, and early promising data for T1b cancers. However, most data is from expert centers and does not report long-term results. Lesion selection needs to be better defined in future large-scale studies.

Summary

The role of ESD has been expanding in the management of Barrett’s esophagus-related neoplasia. We need robust data of prospective nature with a precisely defined cohort of patients to determine the efficacy of ESD over EMR and to position this well in the BE armamentarium.

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References

  1. Bahdi F, Katti CC, Mansour N, et al. Outcomes of endoscopic submucosal dissection (ESD) plus radiofrequency ablation (RFA) for nodular Barrett’s esophagus. Scand J Gastroenterol. 2023;58:123–32.

    Article  PubMed  Google Scholar 

  2. Barret M, Cao DT, Beuvon F, et al. Endoscopic submucosal dissection for early Barrett’s neoplasia. United European Gastroenterol J. 2016;4:207–15.

    Article  CAS  PubMed  Google Scholar 

  3. Chevaux JB, Piessevaux H, Jouret-Mourin A, et al. Clinical outcome in patients treated with endoscopic submucosal dissection for superficial Barrett’s neoplasia. Endoscopy. 2015;47:103–12.

    PubMed  Google Scholar 

  4. Doumbe-Mandengue P, Beuvon F, Belle A, et al. Outcomes of endoscopic submucosal dissection for early esophageal and gastric cardia adenocarcinomas. Clin Res Hepatol Gastroenterol. 2021;45:101700.

    Article  PubMed  Google Scholar 

  5. Höbel S, Dautel P, Baumbach R, et al. Single center experience of endoscopic submucosal dissection (ESD) in early Barrett´s adenocarcinoma. Surg Endosc. 2015;29:1591–7.

    Article  PubMed  Google Scholar 

  6. Joo DC, Kim GH, Lee BE, et al. Endoscopic submucosal dissection for superficial Barrett’s neoplasia in Korea: A single-center experience. J Gastric Cancer. 2021;21:426–38.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Joseph A, Draganov PV, Maluf-Filho F, et al. Outcomes for endoscopic submucosal dissection of pathologically staged T1b esophageal cancer: A multicenter study. Gastrointest Endosc. 2022;96:445–53.

    Article  PubMed  Google Scholar 

  8. Kagemoto K, Oka S, Tanaka S, et al. Clinical outcomes of endoscopic submucosal dissection for superficial Barrett’s adenocarcinoma. Gastrointest Endosc. 2014;80:239–45.

    Article  PubMed  Google Scholar 

  9. Mehta NA, Abe S, Vargo JJ, et al. Insulated-tip knife tunneling and C-shaped incision for esophageal endoscopic submucosal dissection: An initial Western experience. Tech Innov Gastrointest Endosc. 2021;23:152–8.

    Article  Google Scholar 

  10. Motomura D, Bechara R. Single operator experience of endoscopic submucosal dissection for Barrett’s neoplasia in a North American academic center. DEN open. 2022;2:e81.

    Article  PubMed  Google Scholar 

  11. Nagami Y, Machida H, Shiba M, et al. Clinical efficacy of endoscopic submucosal dissection for adenocarcinomas of the esophagogastric junction. Endosc Int Open. 2014;2:E15-20.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Neuhaus H, Terheggen G, Rutz EM, et al. Endoscopic submucosal dissection plus radiofrequency ablation of neoplastic Barretts esophagus. Endoscopy. 2012;44:1105–13.

    Article  CAS  PubMed  Google Scholar 

  13. Osumi H, Fujisaki J, Omae M, et al. Clinicopathological features of Siewert type II adenocarcinoma: Comparison of gastric cardia adenocarcinoma and Barrett’s esophageal adenocarcinoma following endoscopic submucosal dissection. Gastric Cancer. 2017;20:663–70.

    Article  PubMed  Google Scholar 

  14. Othman MO, Bahdi F, Ahmed Y, et al. Short-term clinical outcomes of non-curative endoscopic submucosal dissection for early esophageal adenocarcinoma. Eur J Gastroenterol Hepatol. 2021;33:e700–8.

    Article  CAS  PubMed  Google Scholar 

  15. Probst A, Aust D, Markl B, et al. Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection. Endoscopy. 2015;47:113–21.

    PubMed  Google Scholar 

  16. Probst A, Ebigbo A, Märkl B, et al. Stricture prevention after extensive endoscopic submucosal dissection of neoplastic Barrett’s esophagus: Individualized oral steroid prophylaxis. Gastroenterol Res Pract. 2019;2019:2075256.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Shimizu T, Fujisaki J, Omae M, et al. Treatment outcomes of endoscopic submucosal dissection for adenocarcinoma originating from long-segment Barrett’s esophagus versus short-segment Barrett’s esophagus. Digestion. 2018;97:316–23.

    Article  PubMed  Google Scholar 

  18. Subramaniam S, Chedgy F, Longcroft-Wheaton G, et al. Complex early Barrett’s neoplasia at 3 Western centers: European Barrett’s Endoscopic Submucosal Dissection Trial (E-BEST). Gastrointest Endosc. 2017;86:608–18.

    Article  PubMed  Google Scholar 

  19. van Munster SN, Verheij EPD, Nieuwenhuis EA, et al. Extending treatment criteria for Barrett’s neoplasia: Results of a nationwide cohort of 138 endoscopic submucosal dissection procedures. Endoscopy. 2022;54:531–41.

    Article  PubMed  Google Scholar 

  20. Yang D, Coman RM, Kahaleh M, et al. Endoscopic submucosal dissection for Barrett’s early neoplasia: a multicenter study in the United States. Gastrointest Endosc. 2017;86:600–7.

    Article  PubMed  Google Scholar 

  21. Yang D, King W, Aihara H, et al. Effect of endoscopic submucosal dissection on histologic diagnosis in Barrett’s esophagus visible neoplasia. Gastrointest Endosc. 2022;95:626–33.

    Article  PubMed  Google Scholar 

  22. Codipilly DC, Dhaliwal L, Oberoi M, et al. Comparative outcomes of cap assisted endoscopic resection and endoscopic submucosal dissection in dysplastic Barrett’s esophagus. Clin Gastroenterol Hepatol. 2022;20:65-73.e1.

    Article  PubMed  Google Scholar 

  23. Mejia Perez LK, Yang D, Draganov PV, et al. Endoscopic submucosal dissection vs. endoscopic mucosal resection for early Barrett’s neoplasia in the West: A retrospective study. Endoscopy. 2022;54:439–46.

    Article  PubMed  Google Scholar 

  24. Podboy A, Kolahi KS, Friedland S, et al. Endoscopic submucosal dissection is associated with less pathologic uncertainty than endoscopic mucosal resection in diagnosing and staging Barrett’s-related neoplasia. Dig Endosc. 2020;32:346–54.

    Article  PubMed  Google Scholar 

  25. Terheggen G, Horn EM, Vieth M, et al. A randomised trial of endoscopic submucosal dissection versus endoscopic mucosal resection for early Barrett’s neoplasia. Gut. 2017;66:783–93.

    Article  PubMed  Google Scholar 

  26. Coman RM, Gotoda T, Forsmark CE, et al. Prospective evaluation of the clinical utility of endoscopic submucosal dissection (ESD) in patients with Barrett’s esophagus: A Western center experience. Endoscopy International Open. 2016;4:E715–21.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hoteya S, Matsui A, Iizuka T, et al. Comparison of the clinicopathological characteristics and results of endoscopic submucosal dissection for esophagogastric junction and non-junctional cancers. Digestion. 2013;87:29–33.

    Article  PubMed  Google Scholar 

  28. Yang D, Zou F, Xiong S, et al. Endoscopic submucosal dissection for early Barrett’s neoplasia: A meta-analysis. Gastrointest Endosc. 2018;87:1383–93.

    Article  PubMed  Google Scholar 

  29. Subramaniam S, Kandiah K, Chedgy F, et al. The safety and efficacy of radiofrequency ablation following endoscopic submucosal dissection for Barrett’s neoplasia. Dis Esophagus. 2018;31(3).

  30. Höbel S, Dautel P, Baumbach R, Oldhafer KJ, Stang A, Feyerabend B, Yahagi N, Schrader C, Faiss S. Single center experience of endoscopic submucosal dissection (ESD) in early Barrett’s adenocarcinoma. Surg Endosc. 2015;29(6):1591–7.

    Article  PubMed  Google Scholar 

  31. Sharma P, Shaheen NJ, Katzka D, et al. AGA clinical practice update on endoscopic treatment of Barrett’s esophagus with dysplasia and/or early cancer: Expert review. Gastroenterology. 2020;158:760–9.

    Article  PubMed  Google Scholar 

  32. Weusten B, Bisschops R, Coron E, et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2017;49:191–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology Hepatology and Motility, University of Kansas School of Medicine, Kansas City, KS, USA

    Dhruvil Radadiya MD

  2. Division of Gastroenterology Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, MN, USA

    Madhav Desai MD, MPH

Authors
  1. Dhruvil Radadiya MD
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  2. Madhav Desai MD, MPH
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Correspondence to Madhav Desai MD, MPH.

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Dhruvil Radadiya and Madhav Desai declare no competing interests.

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Radadiya, D., Desai, M. Evolving Role of Endoscopic Submucosal Dissection in the Management of Barrett’s Neoplasia. Curr Treat Options Gastro 21, 231–240 (2023). https://doi.org/10.1007/s11938-023-00429-x

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  • DOI: https://doi.org/10.1007/s11938-023-00429-x

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