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2014 ; 30
(5
): 477-83
Nephropedia Template TP
gab.com Text
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Endoscopic surveillance of gastrointestinal premalignant lesions: current
knowledge and future directions
#MMPMID25003602
Ballester V
; Cruz-Correa M
Curr Opin Gastroenterol
2014[Sep]; 30
(5
): 477-83
PMID25003602
show ga
PURPOSE OF REVIEW: Provide an evidence-based resource for the surveillance of
gastrointestinal premalignant lesions, focusing on the scientific articles
reported recently. RECENT FINDINGS: 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. SUMMARY: 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.