How to manage HGD in patients with Barrett Esophagus?
- HGD is associated with 30% risk of developing EAC. If HGD is confirmed by an expert GI pathologist, there is currently no agreement on the most appropriate management of these patients.
- Treatment options available to patients include intensive endoscopic surveillance with four-quadrant biopsies every 1 cm performed every 3 months, endoscopic ablation therapy, or surgical resection.
- All of these treatment options have produced similar outcomes for patients in retrospective cohort studies performed at expert centers.
- Optimal treatment is therefore determined on a case-by-case basis, taking into account the patient’s age, comorbidities, and ability to comply with an aggressive surveillance program, as well as the available local endoscopic and surgical expertise.
