Bennett C, Green S, Decaestecker J, Almond M, Barr H, Bhandari P, et al. Surgery versus radical endotherapies for early cancer and high-grade dysplasia in Barrett's oesophagus. Cochrane Database Syst Rev 2012 Nov 14;11:CD007334 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23152243.
- How effective is endoscopic management compared with surgical management for high grade dysplasia in patients with BO?
systematic review — Cochrane analyses assessing the literature on the topic of surgery vs endotherapies for early cancer and HGD. There are no RCT - thus each section is a descriptive overview of a comparison of the two techniques.
Excluded 13 published studies comparing surgery and endotherapy in early cancer and HGD as all retrospective and non-randomised. Assessed that bias relates to selection to endoscopic therapy on the grounds of patient factors and not related to stage of disease. Excluded studies reported that patients having endotherapy were older, and had shorter segments of Barrett's. "impossible to reach firm comparison conclusions".
|Low risk of bias||Comments: The recommended evidence is that there is no Level I/II evidence for reasons given previously|
Risk of bias assessment: systematic review
Studies included in the review
- Very thorough – included appropriate search terms and databases
- Yes – pre-specified inclusion criteria applied independently by two people
- Yes – appropriate quality issues were assessed independently by two people
- Yes – summary descriptive tables of subjects, interventions, outcomes etc are provided and estimates of treatment effect displayed
The following questions are only relevant for systematic reviews that pooled data
|5||Reason for decision: There is no formal assessment of this in this review.|
|2||Additional comments: Despite no randomised data the evidence suggests that endoscopic therapy is equivalent to eradication of HGD in the short term with few major side effects.|
- Bennett C, Green S, Decaestecker J, Almond M, Barr H, Bhandari P, et al. Surgery versus radical endotherapies for early cancer and high-grade dysplasia in Barrett's oesophagus. Cochrane Database Syst Rev 2012 Nov 14;11:CD007334 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23152243.
- Assigned to
- Topic area
- Clinical question
Section below only relevant for Cancer Council Project Officer