Barrett's esophagus, towards improved clinical practice

The main clinical relevance of Barrett's esophagus (BE), a result of chronic exposure to gastroesophageal reflux, is its potential progression to esophageal adenocarcinoma (EAC). Although screening for BE is not recommended in the general population, after diagnosis of BE, a surveillance strategy for early detection of dysplasia or neoplasia is needed. The gold standard for diagnosis and surveillance is high-definition oral endoscopy with random biopsies. In addition, any visible lesion should be completely resected, which will be considered curative in the presence of low grade dysplasia (LGD), high-grade dysplasia (HGD) or EAC confined to the mucosa (T1a), followed by eradication of residual BE by endoscopic ablation. In the absence of a visible lesion, radiofrequency ablation should be performed to eradicate BE with LGD, HGD or intramucosal EAC. (C) 2022 Elsevier Espana, S.L.U. All rights reserved.

Automated summary

The main clinical relevance of Barrett's esophagus is its potential progression to esophageal adenocarcinoma. Screening is not recommended for the general population, but surveillance is needed after diagnosis of BE. The gold standard for diagnosis and surveillance is high-definition oral endoscopy with random biopsies. Visible lesions should be completely resected, and in the absence of visible lesions, radiofrequency ablation should be performed.