Esófago de Barrett y cáncer de esófago

Barrett's esophagus is one of the best characterized premalignant lesions, with a standardized incidence of associated esophageal cancer of 6.58 per 100 patients and year. Among the most novel contributions presented at the congress of the American Gastroenterological Association, notable was the demonstration of the potential utility of two imaging techniques - narrow band imaging and Raman spectroscopy - for the identification of lesions with high risk of malignant degeneration in Barrett's esophagus. In addition, a randomized study with a 5-year follow-up demonstrated the efficacy of photodynamic therapy in the treatment of high-grade dysplasia in these patients and that the length of Barrett's esophagus and the loss of the p16 locus are predictive factors for treatment response. Lastly, the results of another study suggest that both endoscopic treatment and surgery are effective in the treatment of high-grade dysplasia and intramucous carcinoma associated with Barrett's esophagus. While the former is associated with a greater risk of tumoral progression, surgery has a higher complication rate and greater initial cost.