Date and Time
February 19, 2003
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Rohini Vij - Trainee

Esophageal adenocarcinoma has the fastest growing incidence rate of all cancers in the United States, with 10,000 new cases each year in the US. Patients usually present with symptoms in later stages, by when the cancer is usually incurable. Heartburn is a known risk factor, and Barrett's esophagus, a change in the lining of the esophagus in response to acid injury, has been identified as a pre-malignant condition. People with severe pre-cancerous changes in Barrett's, called high-grade dysplasia, are especially at risk, though the absolute magnitude of this risk is controversial. Current treatment strategies for patients diagnosed with high-grade dysplasia in Barrett's include surgery to remove the esophagus versus close surveillance with endoscopy to monitor for development of cancer. A new endoscopic treatment, photodynamic therapy, appears to be a promising option for these patients. We performed a cost-effectiveness analysis of photodynamic therapy compared to surveillance and esophagectomy for patients with high-grade dysplasia in Barrett's. When patient preferences are taken into account, photodynamic therapy appears to be a cost-effective strategy. Cancer prevalence, efficacy of PDT and surgical mortality have an important impact on the decision of the optimal treatment option.