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Do the guidelines for management of dysplasia in Barrett’s esophagus reflect current best practice?

Angelika Behrens and Oliver Pech

Guidelines are essential reference points in everyday clinical work. They are intended to provide physicians with essential information for diagnostic and therapeutic decision-making. With regard to the treatment recommendations issued by the various specialist societies on the treatment of dysplasia and early mucosal carcinoma in Barrett’s esophagus, the range of recommendations given (from exclusively local thermal therapy to esophageal resection, recommended as equivalent) is, for the present authors, difficult to understand against the background of the current literature. In the presence of dysplasia or early mucosal carcinoma, endoscopic resection is, in our view, absolutely necessary. Obtaining a histological sample is the central pillar of every type of oncological treatment and should also be regarded as the mandatory standard for neoplasia in Barrett’s esophagus.