PhD defence L. (Laurèlle) van Tilburg

Brief summary of the doctoral thesis:

This thesis evaluates the diagnosis and endoscopic treatment of esophageal neoplasia. Important findings include: 

1. Squamous dysplasia is the most important histological precursor of esophageal squamous cell carcinoma. All patients with esophageal squamous dysplasia, including patients with mild, low grade and moderate dysplasia, have an increased risk of esophageal squamous cell carcinoma diagnosis. 
2. The knowledge among gastroenterologists and head and neck surgeons regarding second primary tumors in patients with head and neck cancer or esophageal cancer is limited. De expectations regarding the yield of screening differ strongly. 
3. in 5% of the patients with head and neck cancer, a second primary tumor in the esophagus is detected with endoscopic screening. Most of these second primary tumors were detected in early stages which could be treated with curative intent.
4. Circumferential endoscopic submucosal dissection is potentially curative in approximately 50% of the patients with early esophageal squamous cell carcinoma. Despite applied stricture prophylaxis in 93%, most patients developed an esophageal stricture (84%). 
5. in 50% of the patients treated with endoscopic resection of neoplasia in a Barrett's esophagus with tumor-positive vertical resection margins, no residual neoplasia was present.