Endoscopic Eradication Therapy for Patients with Barrett’s Esophagus–Associated Dysplasia and Intramucosal Cancer
Publication Date: February 1, 2018
Last Updated: March 14, 2022
Recommendations
1. In BE patients with LGD and HGD being considered for EET, we suggest confirmation of diagnosis by at least 1 expert GI pathologist or panel of pathologists compared with review by a single pathologist. (C, L)
620
2a. In BE patients with LGD, we suggest EET compared with surveillance; however, patients who place a high value on avoiding adverse events related to EET may choose surveillance as the preferred option. (C, M)
620
2b. In BE patients with confirmed HGD, we recommend EET compared with surveillance. (S, M)
620
3. In BE patients with HGD/IMC, we recommend against surgery compared with EET. (S, VL)
620
4. In BE patients referred for EET, we recommend endoscopic resection of all visible lesions compared with no endoscopic resection of visible lesions. (S, M)
620
5. In BE patients with visible lesions who undergo endoscopic resection, we suggest ablation of the remaining Barrett’s segment compared with no ablation. (C, L)
620
6. In BE patients with dysplasia and IMC referred for EET, we recommend against routine complete endoscopic resection of entire Barrett’s segment compared with endoscopic resection of visible lesion followed by ablation of remaining Barrett’s segment. (S, VL)
620
7. In BE patients with dysplasia and IMC who have achieved CE-IM after EET, we suggest surveillance endoscopy versus no surveillance. (C, VL)
620
BE, Barrett’s esophagus; EET, endoscopic eradication therapy; HGD, high-grade dysplasia; LGD, low-grade dysplasia; IMC, intramucosal cancer; CE-IM, complete eradication of intestinal metaplasia
Recommendation Grading
Overview
Title
Endoscopic Eradication Therapy for Patients with Barrett’s Esophagus–Associated Dysplasia and Intramucosal Cancer
Authoring Organization
American Society for Gastrointestinal Endoscopy
Endorsing Organization
American College of Gastroenterology
Publication Month/Year
February 1, 2018
Last Updated Month/Year
June 7, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management, Treatment
Diseases/Conditions (MeSH)
D001471 - Barrett Esophagus, D004938 - Esophageal Neoplasms, D001997 - Bronchopulmonary Dysplasia
Keywords
dysplasia, Barrett’s esophagus, intramucosal cancer