Posttreatment Surveillance, Risk for Recurrence of Barrett's Esophagus, and Adenocarcinoma After Treatment

Esophagectomy or endoscopic eradication therapy, either using endoscopic resection or radiofrequency ablation, cryoablation, or a combination of resection and ablation, aims not only to completely eliminate Barrett's esophagus (BE) dysplasia and early neoplasia but also a complete eradication of intestinal metaplasia (CEIM). We review the existing evidence and propose management strategies that would be applicable to the everyday care of patients with BE after they have received endoscopic or surgical eradication. CEIM is a key initial outcome that requires, at present, validation by endoscopic and histologic assessments. Because of the possibilities for biopsy sampling errors and persistence of buried metaplasia, patients receiving endoscopic therapy or esophagectomy for dysplastic BE should be kept in surveillance until definitive long-term, prospective data become available.