Sub-squamous neoplasia after radiofrequency ablation of Barrett’s oesophagus

Czech version

Authors: P. Slodička; P. Vaněk; T. Tichý; Ondřej Urban
Authors‘ workplace: II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc
Published in: Gastroent Hepatol 2022; 76(3): 218-222
Category: Digestive Endoscopy: Review Article
doi: https://doi.org/10.48095/ccgh2022218

Overview

The term sub-squamous neoplasia or “buried carcinoma” refers to neoplastic processes developing in intestinal metaplasia lesions localised in the lamina propria below the squamous epithelium of the oesophagus. Sub-squamous intestinal metaplasia are located in the transition area between Barrett and squamous epithelium and also beneath neo-squamous epithelium that develops post endoscopic ablation. To date, less than 20 cases of sub squamous neoplasia following successful radiofrequency ablation of Barrett’s oesophagus have been reported in the MedLine database. Knowledge of these conditions is important for adequate follow-up and timely dia gnosis of this potentially fatal complication.

Keywords:

radiofrequency ablation – buried carcinoma – Barrett’s oesophagus – oesophageal adenocarcinoma

Sources

Martínek J, Falt P, Gregar J et al. Standardy České gastroenterologické společnosti – endoskopická léčba pacientů s Barrettovým jícnem a časnými neopláziemi jícnu. Gastroent Hepatol 2013; 67(6): 479–487.
Sharma P, Falk GW, Weston AP et al. Dysplasia and cancer in a large multicenter cohort of patients with Barrett‘s esophagus. Clin Gastroenterol Hepatol 2006; 4(5): 566–572. doi: 10.1016/ j. cgh.2006.03.001.
Martinek J, Benes M, Brandtl P et al. Low incidence of adenocarcinoma and high-grade intraepithelial neoplasia in patients with Barrett‘s esophagus: a prospective cohort study. Endoscopy 2008; 40(9): 711–716. doi: 10.1055/ s-2008-1077502.
Spechler SJ. Dysplasia in Barrett‘s esophagus: limitations of current management strategies. Am J Gastroenterol 2005; 100(4): 927–935. doi: 10.1111/ j.1572-0241.2005.41201.x.
Falt P, Urban O, Fojtík P et al. Radiofrekvenční ablace v terapii Barrettova jícnu – naše první zkušenosti. Endoskopie 2009; 18(3): 118–123.
Titi M, Overhiser A, Ulusarac O et al. Development of subsquamous high-grade dysplasia and adenocarcinoma after successful radiofrequency ablation of Barrett’s esophagus. Gastroenterology 2012; 143(3): 564–566. doi: 10.1053/ j.gastro.2012.04.051.
Nadine Phoa K, van Vilsteren FGI, Weusten BLAM et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA 2014; 311(12): 1209–1217. doi: 10.1001/ jama.2014.2511.
Zavoral M. Mařatkova gastroenterologie: Patofyziologie. Dia gnostika. Léčba. Praha: Karolinum 2021: 428–448.
Phoa KN, Pouw RE, van Vilsteren FGI et al. Remission of Barrett‘s esophagus with early neoplasia 5 years after radiofrequency ablation with endoscopic resection: a Netherlands cohort study. Gastroenterology 2013; 145(1): 96–104. doi: 10.1053/ j.gastro.2013.03.046.
Krajciova J, Janicko M, Falt P et al. Radiofreqency ablation in patients with Barrett’s esophagus related neoplasia – long-term outcomes of the Czech national RFA database. J Gastrointest Liver Dis 2019; 28: 149–155. doi: 10.15403/ jgld-174.
Vrba R. Karcinom jícnu: Průvodce pro chirurgickou a gastroenterologickou praxi. Praha: Maxdorf 2021: 49–72.
Spechler SJ, Fitzgerald RC, Prasad GA et al. History, molecular mechanisms, and endoscopic treatment of Barrett‘s esophagus. Gastroenterology 2010; 138(3): 854–869. doi: 10.1053/ j. gastro.2010.01.002.
Spechler SJ, Souza RF. Biomarkers and photodynamic therapy for Barrett‘s esophagus: time to FISH or cut bait? Gastroenterology 2008; 135(2): 354–357. doi: 10.1053/ j. gastro.2008.06.065.
Overholt BF, Wang KK, Burdick JS et al. Five- -year efficacy and safety of photodynamic therapy with Photofrin in Barrett‘s high-grade dysplasia. Gastrointest Endosc 2007; 66(3): 460–468. doi: 10.1016/ j.gie.2006.12.037.
Qumseya BJ, David W, Wolfsen HC. Photodynamic therapy for Barrett‘s esophagus and esophageal carcinoma. Clin Endosc 2013; 46(1): 30–37. doi: 10.5946/ ce.2013.46.1.30.
Kajzrlikova I, Vitek P, Falt P et al. Recurrent oesophageal intramucosal squamous carcinoma treated by endoscopic mucosal resection and subsequent radiofrequency ablation using HALO system. BMJ Case Rep 2010; 2010: bcr0820103211. doi: 10.1136/ bcr.08.2010.3211.
Spechler SJ, Souza RF. Stem cells in Barrett‘s esophagus: HALOs or horns? Gastrointest Endosc 2008; 68(1): 41–43. doi: 10.1016/ j. gie.2008.02.080.
Suchánek Š, Martínek J, Zavoral M. První radiofrekvenční ablace Barrettova jícnu s využitím HALO systému v České republice. Endoskopický workshop. Čes a Slov Gastroent a Hepatol 2009; 63(4): 195–196.
Shaheen NJ, Overholt BF, Sampliner RE et al. Durability of radiofrequency ablation in Barrett’s esophagus with dysplasia. Gastroenterology 2011; 141(2): 460–468. doi: 10.1053/ j. gastro.2011.04.061.
Fleischer DE, Overholt BF, Sharma VK et al. Endoscopic radiofrequency ablation for Barrett‘s esophagus: 5-year outcomes from a prospective multicenter trial. Endoscopy 2010; 42(10): 781–789. doi: 10.1055/ s-0030-1255779.
Lyday WD, Corbett FS, Kuperman DA et al. Radiofrequency ablation of Barrett‘s esophagus: outcomes of 429 patients from a multicenter community practice registry. Endoscopy 2010; 42(4): 272–278. doi: 10.1055/ s-0029-1243883.
Hernandez JC, Reicher S, Chung D et al. Pilot series of radiofrequency ablation of Barrett’s esophagus with or without neoplasia. Endoscopy 2008; 40(5): 388–392. doi: 10.1055/ s-2007-995747.
Castela J, Serrano M, Mão de Ferro S et al. Buried Barrett’s esophagus with high-grade dysplasia after radiofrequency ablation. Clin Endosc 2019; 52(3): 269–272. doi: 10.5946/ ce.2018.124.
Shand A, Dallal H, Palmer K et al. Adenocarcinoma arising in columnar lined oesophagus following treatment with argon plasma coagulation. Gut 2001; 48(4): 580–581. doi: 10.1136/ gut.48.4.580b.
Van Laethem JL, Peny MO, Salmon I et al. Intramucosal adenocarcinoma arising under squamous re-epithelialisation of Barrett‘s oesophagus. Gut 2000; 46(4): 574–577. doi: 10.1136/ gut. 46.4.574.
Prasad GA, Wang KK, Halling KC et al. Utility of bio markers in prediction of response to ablative therapy in Barrett‘s esophagus. Gastroenterology 2008; 135(2): 370–379. doi: 10.1053/ j. gastro.2008.04.036.
Hornick JL, Mino-Kenudson M, Lauwers GY et al. Buried Barrett‘s epithelium following photodynamic therapy shows reduced crypt proliferation and absence of DNA content abnormalities. Am J Gastroenterol 2008; 103(1): 38–47. doi: 10.1111/ j.1572-0241.2007.01560.x.
Yang LS, Holt BA, Williams R et al. Endoscopic features of buried Barrett‘s mucosa. Gastrointest Endosc 2021; 94(1): 14–21. doi: 10.1016/ j. gie.2020.12.031.
Kaul V. Optical coherence tomography for Barrett esophagus. Gastroenterol Hepatol (N Y) 2018; 14(4): 253–255.
Kirtane TS, Wagh MS. Endoscopic optical coherence tomography (OCT): advances in gastrointestinal imaging. Gastroenterol Res Pract 2014; 2014: 376367. doi: 10.1155/ 2014/ 376 367.
Leggett CL, Gorospe EC, Chan DK et al. Comparative dia gnostic performance of volumetric laser endomicroscopy and confocal laser endomicroscopy in the detection of dysplasia associated with Barrett’s esofagus. Gastrointest Endosc 2016; 83(5): 880–888. doi: 10.1016/ j. gie.2015.08.050.
Swager AF, de Groof AJ, Meijer SL et al. Feasibility of laser marking in Barrett‘s esophagus with volumetric laser endomicroscopy: first- -in-man pilot study. Gastrointest Endosc 2017; 86(3): 464–472. doi: 10.1016/ j.gie.2017.01.030.
Gray NA, Odze RD, Spechler SJ. Buried metaplasia after endoscopic ablation of Barrett‘s esophagus: a systematic review. Am J Gastroenterol 2011; 106(11): 1899–1908. doi: 10.1038/ ajg.2011.255.
Bronner MP, Overholt BF, Taylor SL et al. Squamous overgrowth is not a safety concern for photodynamic therapy for Barrett‘s esophagus with high-grade dysplasia. Gastroenterology 2009; 136(1): 56–64. doi: 10.1053/ j. gastro.2008.10.012.
Chennat J, Ross AS, Konda VJ et al. Advanced pathology under squamous epithelium on initial EMR specimens in patients with Barrett‘s esophagus and high-grade dysplasia or intramucosal carcinoma: implications for surveillance and endotherapy management. Gastrointest Endosc 2009; 70(3): 417–421. doi: 10.1016/ j.gie.2009.01.047.
Sharma P, Morales TG, Bhattacharyya A et al. Squamous islands in Barrett‘s esophagus: what lies underneath? Am J Gastroenterol 1998; 93(3): 332–335. doi: 10.1111/ j.1572-0241. 1998.00332.x.
Chabrun E, Marty M, Zerbib F. Development of esophageal adenocarcinoma on buried glands following radiofrequency ablation for Barrett’s esophagus. Endoscopy 2012; 44(Suppl 2): E392. doi: 10.1055/ s-0032-1310 245.
Slodička P. Kvíz z klinické praxe. Gastroent Hepatol 2021; 75(4): 284–285.
Konda VJA, Gonzalez M, Ruiz H et al. Development of subsquamous cancer after hybrid endoscopic therapy for intramucosal Barrett‘s cancer. Endoscopy 2012; 44(Suppl 2): E390–391. doi: 10.1055/ s-0032-1310139.
Lee JK, Cameron RG, Binmoeller KF et al. Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett‘s esophagus. Endoscopy 2013; 45(7): 571–574. doi: 10.1055/ s-0032-1326419.
Kohoutova D, Haidry R, Banks M et al. Esophageal neoplasia arising from subsquamous buried glands after an apparently successful photodynamic therapy or radiofrequency ablation for Barrett‘s associated neoplasia. Scand J Gastroenterol 2015; 50(11): 1315–1321. doi: 10.3109/ 00365521.2015.1043578.
Oumrani S, Barret M, Beuvon F et al. Buried esophageal adenocarcinoma after radiofrequency ablation. Clin Res Hepatol Gastroenterol 2019; 43(1): 3–4. doi: 10.1016/ j. clinre.2018.02.006.
Kumar P, Gordon IO, Thota PN. Post-ablation buried neoplasia in Barrett‘s esophagus. Scand J Gastroenterol 2021; 56(5): 624–628. doi: 10.1080/ 00365521.2021.1896774.