ENDOSCOPIC TREATMENT FOR BARRETT’S ADENOCARCINOMA

Abstract

In Japan, the basic treatment strategy for Barrettʼs adenocarcinoma is en bloc resection of the lesion using ESD, followed by careful surveillance of the residual Barrettʼs esophagus. Contrastingly, although Japan and Western countries have many differences regarding diagnosis and treatment, the most significant difference is the therapeutic goals of endoscopic treatment. In Western practice, after endoscopic resection of visible lesions, ablation therapy, such as RFA is applied to the residual Barrettʼs esophagus, aiming to completely eradicate the Barrettʼs esophagus. This is termed endoscopic eradication therapy and constitutes the standard treatment strategy in Western countries. This article addresses these Japanese-Western differences and discusses the current challenges and future perspectives in Japan.