Endoscopic Surveillance Of Barrett'S Esophagus: Is It Worthwhile?

Aim of this study was to assess the impact of endoscopic biopsy surveillance on outcome of Barrett's adenocarcinoma. Between November 1992 and June 2000, 97 patients with Barrett's adenocarcinoma were observed. In 12 (12.2%) of these patients, cancer was discovered during endoscopic biopsy surveillance for Barrett's metaplasia. In the surveyed group, there were 9 (75%) early stage tumors (Tis-1NO), versus 9 (10.6%, p<0.01) in the non-surveyed patients. Three out of five surveyed patients operated on for high grade dysplasia proved to have invasive carcinoma in the esophagectomy specimen. All surveyed patients were alive at a median follow-up of 52 months (range 8-72); the median survival in the nonsurveyed group was 24+/-3 months (p<0.01). Endoscopic surveillance of Barrett's esophagus provides early detection of adenocarcinoma and a better long-term survival than in the non-surveyed patients.