Medical services

The different clinical services constitute the backbone on which the healthcare activity of MD Anderson Cancer Center Madrid is organised.


Unidad Especializada de Esófago de Barrett

La Unidad de Esófago de Barrett es una unidad especializada constituida por los servicios de Digestivo y Cirugía Digestiva del MD Anderson Cancer Center Madrid. Esta Unidad está dirigida a aquellos pacientes que hayan presentado displasia o carcinoma precoz asociado al Esófago de Barrett. A tal fin se ofrecerá en nuestro centro una atención profesional especializada, dirigida al adecuado tratamiento y seguimiento de estos pacientes.

Barrett’s Esophagus is a condition defined by the presence of metaplastic columnar epithelium replacing squamous epithelium in the esophagus. This histological change is the result of prolonged gastroesophageal reflux (gastroesophageal reflux disease – GERD). One the characteristics of Barrett’s Esophagus is that it increases the risk of developing esophageal adenocarcinoma, a neoplasia with increased incidence in the west and associated with a negative prognosis in its advanced stages. It is estimated that the annual incidence of adenocarcinoma among the population with Barrett’s Esophagus is from 0.1%-2%, 30 times higher than for the general population.

Barrett’s Esophagus is particularly common among white men, with a certain degree of obesity and a history of prolonged pyrosis (gastroesophageal reflux disease). Detecting Barrett’s Esophagus is particularly important to be able to carry out adequate long-term monitoring and to detect the first forms of dysplasia/adenocarcinoma early by means of a gastroscopy. In recent years, endoscopic treatment techniques have been developed for early forms of dysplasia/adenocarcinoma on Barrett’s Esophagus, allowing the complete cure of the disease and a reduction of the posterior risk of developing new neoplasias. Among these techniques, and of particular interest, are endoscopic mucosectomy and radiofrequency endoscopic ablation.

  • Gastroscopy with chromoendoscopy with a special biopsy protocol for the correct diagnosis and posterior monitoring of Barrett’s Esophagus with dysplasia.
  • Endoscopic Musectomy for the treatment of visible lesions associated with Barrett’s Esophagus.
  • Radiofrequency Ablation to eradicate diseased epithelium (intestinal metaplasia) in patients diagnosed with dysplasia or adenocarcinoma, to reduce the risk of relapse.
  • Upper Echoendoscopy for local staging of esophageal cancer.
  • Laparascopic antireflux surgery techniques in selected cases requiring adequate control of gastroesophageal reflux disease.
  • Oncologic esophagectomy techniques for cases that cannot be treated using endoscopic techniques.

Currently, clinical guides recommend the single or combined use of Endoscopic mucosectomy and Radiofrequency Ablation to treat patients with high grade dysplasia and/or intramucous adenocarcinoma associated with Barrett’s Esophagus.

Endoscopic Mucosectomy consists of resecting segments of mucous and submucous from the esophagus by means of special techniques. The results of studies carried out using the Endoscopic Mucosectomy technique to treat high grade dysplasia and intramucous adenocarcinoma show complete cure and survival rates at 5 years of between 85-98%.

Radiofrequency Endoscopic Ablation (RFA) uses the HALO system (BARRX Medical, Sunnyvale, California) which makes it possible to submit the tissue to radiofrequency energy applied by means of balloons adjusted uniformly to the circumference of the esophagus. Radiofrequency Endoscopic Ablation allows the homogeneous elimination of the diseased epithelium of Barrett’s Esophagus, so that the future risk of new areas of dyplasia/adenocarcinoma is remarkably reduced in people diagnosed and/or treated.