Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett’s esophagus: An Italian experience

Table 1 Characteristics of patients and lesions according to histology of mucosa resected at EMR (mean±SD)

	LGD	HGD	IMC	SMC
				(no surgery)
Age (yr)	60.6±8.8	61.76±11.8	56±4.2	73.6±8.3
BE length (cm)	6.6±4.1	3.6±1.8	3.7±1.8	5.8±3.1
Size of lesion (mm)	22.5±8.7	13±10.2	16±5.7	17.6±11.9
Metachronous lesion (%)
No	5 (100)	24 (88.9)	2 (100)	2 (100)
Yes	-	1 (3.7)	-	-
No follow-up endoscopy (%)	-	2 (7.4)	-	-
Total	5	27	2	2

LGD: low-grade dysplasia; HGD: high-grade dysplasia; IMC: intramucosal cancer; SMC: submucosal cancer; BE: Barrett’s esophagus.

Table 2 Selected studies on EMR in Barrett’s esophagus

Author	Number of patiens	Size of lesionscm (mean)	Technique	Histologypre-EMR	Histologypost-EMR	Change in diagnosis (%)	Complications	Follow-upmonths(mean)	Recurrence
Seewald et al 2003 Germany[24]	12	Median 5	EUS Snare	5 HGD/ IMC (visible) 7 IMC	2 BE 1 LGD 5 HGD	75%	Bl: 33% Stricture:17%	Median: 9	0
				(non-visible)
					AC 4
Ahmad et al 2002	19/101	0.5-3	EUS	AC 6	AC 8	58%	Bl: 11%	>=24	0
USA[33]			EMR-C	HGD 6	HGD 4
			Snare	NOS 7	LGD 1
			injection		Benign 6
May et al 2002	80	Nos	EUS	HGD 7	AC: 11/80	Nos	Bl: 6%	34	24/78
Germany[17]			EMR±PDT	EC 73			Stricture: 4%

Table 3 Selected studies on EMR in Barrett’s esophagus

Author	Number of pts	Size of lesionscm (mean)	Technique	Histologypre-EMR	Histologypost-EMR	Change in diagnosis (%)	Complications	Follow-upMonths(mean)	Recurrence
Buttar et al 2001 USA[34]	17	8	EUS VLD-PDT	IMC: 7 AC: 10	IMC: 7 AC: 10	47%	Bl: 6% Stricture: 30%	13	HGD (1)1 AC (1)
			Injection
Nijhawan et al 2000 USA[35]	25	7	EUS Lift-and-cut VLD	2 BE 8 LGD 5 HGD	2 BE 3 LGD 5 HGD	48%	0	14.6	0
			Injection	9 AC	13 AC
				1 other	2 other
Ell et al 2000	35	0.9	EUS	HGD: 3	HGD: 3	0	Bl: 20%	12	11%
Germany[36]			EMR±	EC: 32	EC: 32
			injection

Pts: patients; EMR: endoscopic mucosal resection; EUS: endoscopic ultrasonography; HGD: high-grade dysplasia; IMC: intramucosal carcinoma; BE: Barrett's esophagus; LGD: low-grade dysplasia; AC: invasive adenocarcinoma; Bl: bleeding; EMR-C: EMR with cap; PDT: photodynamic therapy; Nos: not otherwise specified; VLD: variceal ligator device; EC: early cancer;

¹persistence of HGD.