Long term care after successful endoscopic therapy in Barrett’s esophagus patients: a review of literature

Abstract

Barrett’s esophagus (BE), a precursor to esophageal adenocarcinoma (EAC) has demonstrated a steep rise in incidence in the last few decades. Patients with high grade dysplasia and/or intramucosal carcinoma are indeed at a higher risk of progression to invasive cancer. Early recognition and endoscopic management could be curative. There have been significant strides in the endoscopic eradication therapy (EET) using resection and ablation techniques in the last 2 decades for management of BE with dysplasia. Once complete eradication is achieved after EET, it is important to follow-up these patients for complications and recurrence. While the importance of this long term-care is appreciated, there is a paucity of studies outlining long-term outcomes and post-therapy follow-up care data. Currently, the same aggressive principles used for original BE with neoplasia are being followed for subjects in remission. Precise definitions of follow up care and quality standards in maintaining durable efficacy are required. Novel techniques and biomarkers have been proposed to assist in the diagnosis and risk stratification but their role in this setting is still unclear. In this review, we present the literature and data on follow up and long-term care of BE patients after successful endoscopic therapy for BE associated dysplasia.