Barrett esophagus: A sequela of chemotherapy

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Abstract

In most cases, Barrett esophagus develops when injured esophageal squamous epithelium is replaced by columnar mucosa in the abnormal environment of chronic gastroesophageal reflux. In this issue of Annals, Sartori and colleagues present compelling evidence that Barrett epithelium can also be acquired as a sequela of chronic chemotherapy with antineoplastic agents capable of inducing mucositis. Presumably, these agents injure the esophageal squamous mucosa, which, in the abnormal environment of chronic chemotherapy, is replaced by a more resistant columnar epithelium. Reflux-associated Barrett esophagus is known to predispose to esophageal cancer, and regular endoscopic surveillance for this tumor is advised for affected patients. The risk for malignancy in patients with a columnar cell-lined esophagus induced by chemotherapy is not known, and hence the need for regular endoscopic surveillance in such patients has not been established. Specific recommendations for patient management cannot be made until further studies elucidate the risks associated with chemotherapy-induced Barrett esophagus.

Original languageEnglish (US)
Pages (from-to)243-244
Number of pages2
JournalAnnals of internal medicine
Volume114
Issue number3
DOIs
StatePublished - Jan 1 1991

Keywords

  • Barrett esophagus
  • Cyclophosphamide
  • Endoscopy
  • Fluorouracil
  • Methotrexate

ASJC Scopus subject areas

  • Internal Medicine

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