Esophageal neoplasia arising from subsquamous buried glands after an apparently successful photodynamic therapy or radiofrequency ablation for Barrett’s associated neoplasia

Kohoutová, Darina; Haidry, Rehan; Banks, Matthew; Bown, Stephen G.; Sehgal, Vinay; Butt, Mohammed A.; Graham, David; Thorpe, Sally; Novelli, Marco; Rodriguez‐Justo, Manuel; Lovat, Laurence

doi:10.3109/00365521.2015.1043578

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…The findings in this paper lend further support to the notion that EMR and RFA are better treatment options for patients with dysplastic BE. RFA is also associated with less frequent buried metaplasia (1%) when compared to PDT (14%) and therefore possible subsequent development of sub-squamous neoplasia should be less likely [26]. In conclusion, PDT alone does not offer a valuable long-term treatment for dysplastic Barrett's oesophagus.…”

Section: Discussionmentioning

confidence: 92%

Long-term outcomes of the randomized controlled trial comparing 5-aminolaevulinic acid and Photofrin photodynamic therapy for Barrett’s oesophagus related neoplasia

Kohoutová

Haidry

Banks

et al. 2017

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 92%

Long-term outcomes of the randomized controlled trial comparing 5-aminolaevulinic acid and Photofrin photodynamic therapy for Barrett’s oesophagus related neoplasia

Kohoutová

Haidry

Banks

et al. 2017

Scandinavian Journal of Gastroenterology

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“…Titi et al were the first to describe neosquamous neoplasia after the successful RFA of dysplastic BE [6]. Table 1 summarizes the cases of buried neoplasia after successful RFA of BE published to the date [6,12-15]. Fewer than 20 cases of subsquamous neoplasia after the successful RFA of BE have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…In the present case, the subsquamous HGD area was detected 4 years after the last RFA session. It is unclear whether it progressed from buried glands with dysplasia ab initio and was inadequately eradicated and remained quiescent for this long period of time or if it was derived from non-dysplastic buried glands with the development of a de novo lesion [15]. Considering the last hypothesis, the most acceptable pathways of cellular reprogramming in Barrett’s metaplasia are transdifferentiation (direct or via squamous cell de-differentiation) and transcommitment (from the esophageal submucosal glands, gastric cardia/gastroesophageal junction epithelium, or circulating bone marrow–derived progenitor cells) [19].…”

Section: Discussionmentioning

confidence: 99%

Buried Barrett’s Esophagus with High-Grade Dysplasia after Radiofrequency Ablation

Castela¹,

Serrano²,

Ferro³

et al. 2019

Clin Endosc

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Radiofrequency ablation therapy is an effective endoscopic option for the eradication of Barrett’s esophagus that appears to reduce the risk of esophageal cancer. A concern associated with this technique is the development of subsquamous/buried intestinal metaplasia, whose clinical relevance and malignant potential have not yet been fully elucidated. Fewer than 20 cases of subsquamous neoplasia after the successful radiofrequency ablation of Barrett’s esophagus have been reported to date. Here, we describe a new case of subsquamous neoplasia (high-grade dysplasia) following radiofrequency ablation that was managed with endoscopic resection. Our experience suggests that a meticulous endoscopic inspection prior to and after radiofrequency ablation is fundamental to reduce the risk of buried neoplasia development.

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“…Another theory proposes the development of new buried glands following ablation therapy. 54 The prevalence of buried metaplasia varied from 25.2% to 72% in some studies. 19,55 The prevalence appears to decrease after ablative therapy.…”

Section: Limitations Of Eetmentioning

confidence: 98%

Indications, contraindications and limitations of endoscopic therapy for Barrett’s esophagus and early esophageal adenocarcinoma

Rouphael

Kumar

Sanaka

et al. 2020

Therap Adv Gastroenterol

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Endoscopic eradication therapy (EET) has revolutionized management of Barrett’s esophagus (BE)-associated neoplasia, traditionally treated by esophagectomy, which carries very high mortality and morbidity. EET, usually performed in the outpatient setting, has a safe risk profile. It is indicated in patients with BE with high-grade dysplasia and intramucosal cancer, confirmed, and persistent low-grade dysplasia, and in highly selected cases of non-dysplastic BE and submucosal cancers. Multiple EET modalities are available and can be categorized into two groups: ablation therapies and resection techniques with resection techniques usually reserved for nodular/raised lesions or lesions with suspected neoplasia. Patients usually require multiple ablation sessions with a goal of achieving complete eradication of metaplasia. Despite very good results, EET has its limitations and is not 100% effective: it targets a small subset of patients along the spectrum of BE and esophageal adenocarcinoma, as most patients with esophageal adenocarcinoma remain asymptomatic until the disease has progressed to advanced stages. Post-ablation surveillance is mandatory, as recurrences are common. An area of concern is buried metaplasia reported to occur following ablation therapy and thought to be from de novo growth of metaplastic tissue underneath the neosquamous epithelium, following ablation. The focus of this review article is to present the indications, contraindications and limitations of EET.

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Esophageal neoplasia arising from subsquamous buried glands after an apparently successful photodynamic therapy or radiofrequency ablation for Barrett’s associated neoplasia

Cited by 14 publications

References 23 publications

Long-term outcomes of the randomized controlled trial comparing 5-aminolaevulinic acid and Photofrin photodynamic therapy for Barrett’s oesophagus related neoplasia

Long-term outcomes of the randomized controlled trial comparing 5-aminolaevulinic acid and Photofrin photodynamic therapy for Barrett’s oesophagus related neoplasia

Buried Barrett’s Esophagus with High-Grade Dysplasia after Radiofrequency Ablation

Indications, contraindications and limitations of endoscopic therapy for Barrett’s esophagus and early esophageal adenocarcinoma

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