Oesophagectomy remains the gold standard for treatment of high-grade dysplasia in Barrett's oesophagus

The goal of surveillance in Barrett's oesophagus is to detect high-grade dysplasia (HGD). The natural history of HGD is unclear, but because of the reported high risk of coexistent invasive carcinoma, oesophagectomy is currently the gold standard treatment. Recent reports suggest the risk of coexistent tumour may be lower and that the optimum treatment for HGD is continuing surveillance or mucosal ablation treatment, reserving oesophagectomy for those patients with invasive malignancy. To re-examine the role of oesophagectomy we looked at the incidence of invasive cancer in patients undergoing resection for HGD and their subsequent outcome.