The Impact of Neoadjuvant Chemoradiation Therapy on Non-Tumorous Barrett’s Dysplasia of the Esophagus - A Multicenter Cohort Study

Q: What was the study’s objective regarding NCRT in EAC patients?

To evaluate how neoadjuvant chemoradiation therapy affects BE segment length and dysplasia in patients undergoing esophagectomy for EAC.

Q: How was BE regression assessed between the NCRT and control groups?

Pre- and postoperative pathology was compared to evaluate BE regression, with the NCRT group showing significantly higher regression than control (77.8% vs 10%, p < 0.001).

Q: What conclusions were drawn about the impact of NCRT on BE and dysplasia?

NCRT significantly reduced BE and dysplasia, suggesting improved surgical outcomes by minimizing residual disease, while further research is needed to clarify mechanisms and refine treatment strategies.

Sep 30, 2026

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Barrett’s esophagus (BE) is a precursor to esophageal adenocarcinoma (EAC), and neoadjuvant chemoradiation therapy (NCRT) is frequently used for EAC, yet its effect on non-tumorous BE and dysplasia remains unclear. A multicenter retrospective cohort evaluated EAC patients undergoing esophagectomy with or without NCRT, comparing pre- and postoperative pathology. The NCRT group showed markedly higher BE regression (77.8% vs 10%, p < 0.001) and reduced residual dysplasia, with dysplasia regression 66.7% vs 20%.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Keywords

1. Introduction

1.1. Epidemiology and Clinical Significance

1.2. Diagnosis and Risk Stratification

Article The Impact of Neoadjuvant Chemoradiation Therapy on Non-Tumorous Barrett’s Dysplasia of the Esophagus: AMulticenter Cohort Study Vismaya S. Bachu 1, Jay M. Lee 2, Hanlin L. Wang 3, Phillip Kozan 4, Melanie Ramirez 1, Jose Garcia-Corella 5, Kevin A. Ghassemi 4, Venkataraman Muthusamy 4 and Danny Issa 1,4, * Academic Editor: Masahiro Tajika Received: 18 November 2025 Revised: 20 December 2025 Accepted: 25 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; [vbachu@mednet.ucla.edu](vbachu@mednet.ucla.edu) (V.S.B.); [meramirez@mednet.ucla.edu](meramirez@mednet.ucla.edu) (M.R.) 2 Thoracic Oncology Program, Division of Thoracic Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA; [jaymoonlee@mednet.ucla.edu](jaymoonlee@mednet.ucla.edu) 3 Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; [hanlinwang@mednet.ucla.edu](hanlinwang@mednet.ucla.edu) 4 Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; [pkozan@mednet.ucla.edu](pkozan@mednet.ucla.edu) (P.K.); [kghassemi@mednet.ucla.edu](kghassemi@mednet.ucla.edu) (K.A.G.); [raman@mednet.ucla.edu](raman@mednet.ucla.edu) (V.M.) 5 Internal Medicine, University of California Los Angeles (UCLA)–Kern Medical, Bakersfield, CA 93305, USA; [jose.garciacorella@kernmedical.com](jose.garciacorella@kernmedical.com) * Correspondence: [dissa@mednet.ucla.edu](dissa@mednet.ucla.edu) Abstract Background/Objectives: Barrett’s esophagus (BE) is a precursor to esophageal adenocarcinoma (EAC), and neoadjuvant chemoradiation therapy (NCRT) is commonly used in the treatment of EAC. However, the impact of NCRT on non-tumorous BE and dysplasia is poorly understood. Our study aims to evaluate the effects of NCRT on BE segment length and dysplasia in patients undergoing esophagectomy for EAC. Methods: This multicenter, retrospective cohort study includes EAC patients who underwent esophagectomy with or without NCRT between 2014 and 2020 . Patients with histologically confirmed BE and dysplasia (low-or high-grade) were analyzed. Preoperative and postoperative pathology were compared to assess BE regression, dysplastic changes, and segment length. Statistical analyses included chi-square and t-tests, with p < 0.05 considered significant. Results: Of 101 patients who were diagnosed with EAC, 28 patients were found to have BE, with 18 receiving NCRT in addition to surgery and 10 undergoing surgery alone. The NCRT group showed significantly higher BE regression than the control group (77.8% versus 10%, p < 0.001) . Regression of dysplasia occurred in 66.7% of the NCRT group versus 20% of the control group (p = 0.079) and residual dysplasia was lower in the NCRT group (33.3%) compared to the control group (80%) (p = 0.018) . Conclusions: NCRT significantly reduces BE and dysplasia, suggesting it may improve surgical outcomes by minimizing residual disease. These findings support the potential of NCRT to enhance surgical precision in EAC treatment, though further research is needed to explore underlying mechanisms andrefine treatment strategies. Keywords: Barrett’s esophagus; esophageal adenocarcinoma; neoadjuvant chemoradiation therapy; dysplasia; esophagectomy; multicenter study 1. Introduction 1.1. Epidemiology and Clinical Significance Barrett’s esophagus (BE), defined by the metaplastic transformation of distal esophageal squamous epithelium into specialized columnar epithelium, is the established precursor to esop

FAQs

What was the study’s objective regarding NCRT in EAC patients?

To evaluate how neoadjuvant chemoradiation therapy affects BE segment length and dysplasia in patients undergoing esophagectomy for EAC.

How was BE regression assessed between the NCRT and control groups?

Pre- and postoperative pathology was compared to evaluate BE regression, with the NCRT group showing significantly higher regression than control (77.8% vs 10%, p < 0.001).

What conclusions were drawn about the impact of NCRT on BE and dysplasia?

NCRT significantly reduced BE and dysplasia, suggesting improved surgical outcomes by minimizing residual disease, while further research is needed to clarify mechanisms and refine treatment strategies.

Sep 30, 2026

Upload by WPS_1790064749