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Endoscopic surveillance of gastrointestinal premalignant lesions: current knowledge and future directions.
[esophageal adenocarcinoma]
Provide
an
evidence-based
resource
for
the
surveillance
of
gastrointestinal
premalignant
lesions
,
focusing
on
the
scientific
articles
reported
recently
.
No
randomized
controlled
clinical
trials
exist
to
definitively
support
the
efficacy
of
surveillance
programs
for
Barrett
's
esophagus
and
gastric
intestinal
metaplasia
.
However
,
surveillance
of
these
premalignant
lesions
is
recommended
by
some
of
the
leading
organizations
.
To
optimize
the
usefulness
of
surveillance
programs
,
targeting
high
-risk
patients
might
maximize
its
benefits
.
A
Barrett
's
esophagus
segment
of
at
least
3
 
cm
and
evidence
of
intestinal
metaplasia
can
help
stratify
those
patients
at
highest
risk
for
progression
to
esophageal
adenocarcinoma
.
The
location
,
extent
,
and
severity
of
intestinal
metaplasia
are
indicators
of
risk
of
developing
gastric
cancer
.
Patients
with
extensive
intestinal
metaplasia
should
be
offered
endoscopic
surveillance
.
Quality
in
the
baseline
colonoscopy
is
crucial
to
decrease
the
risk
of
interval
colorectal
cancers
.
The
importance
of
serrated
polyps
,
as
well
as
their
surveillance
intervals
,
is
emphasized
.
To
optimize
the
usefulness
of
surveillance
programs
,
targeting
high
-risk
patients
might
maximize
its
benefits
.
Future
research
is
needed
to
design
more
effective
surveillance
strategies
.
Recently
,
emerging
imaging
techniques
hold
promise
for
improving
sensitivity
of
endoscopic
surveillance
of
premalignant
conditions
in
the
gastrointestinal
tract
.
