Durability of Endoscopic Treatment for Dysplastic Barrett's Esophagus

This review discusses the durability of the neo-squamous esophageal epithelium following endoscopic eradication therapy of dysplastic Barrett's esophagus. Our review will focus primarily on patients treated with radiofrequency ablation; however, we describe the known durability of cryotherapy. Additionally, we discuss the utility of novel imaging technologies and the efficacy of chemopreventive medications following endoscopic ablation.

Mounting data describe the durability of the post-ablation esophagus. Dysplastic Barrett's esophagus and adenocarcinoma following ablation are rare. New data emphasize that most recurrent disease occurs in the initial year following treatment. Additionally, recent publications suggest that a much-attenuated surveillance interval may provide adequate detection of neoplasia with many fewer surveillance endoscopies. Future guidelines will likely liberalize surveillance intervals following endoscopic eradication therapy. Additionally, further longitudinal studies will need to assess the length of time for which surveillance is indicated. The utility of chemopreventive strategies and adjunctive imaging modalities in the maintenance and surveillance of the post-ablation esophagus also remain unclear and will be areas for future investigation.