The Society of Thoracic Surgeons Practice Guideline Series: Guidelines for the Management of Barrett's Esophagus With High-Grade Dysplasia

Diagnosis and Management of Barrett’s Esophagus with and Without Dysplasia

“…Reported mortality rates for esophagectomy usually were based on outcomes after surgery for cancer and not HGD. It is well known that patients with cancers are older, more morbid, and have more comorbidities than patients with HGD alone [257]. On the other hands the results from high-volume centers with greater surgical expertise have shown better outcomes [224].…”

Guidelines for the management of Barrett esophagus with high-grade dysplasia?

“…1 Once there is HGD in Barrett mucosa, there is a high risk of cancer. The STS guideline considers 4 treatment options: endoscopic surveillance, mucosal ablation, EMR and esophagectomy.…”

“…1 The key to practising evidencebased medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding.…”

Shining light on Barrett’s esophagus

“…However, as GERD and BE are relatively frequent in the general population, and only a fraction of individuals ever develop EADC [17], it is likely that molecular and lifestyle risk factors interact to modulate individual susceptibility to malignant progression [18][19][20]. The incorporation of clinically relevant molecular markers into future screening and endoscopic surveillance programs [21][22][23][24] may well identify individuals with BE who are at increased risk for progression to invasive EADC, thereby providing a unique opportunity for early intervention, and potentially improved outcomes for this disease [25].…”