# Antireflux Surgery for Barrett's Esophagus: Where Do We Stand in Preventing Esophageal Adenocarcinoma?

**Authors:** Dagmar Kollmann, Cansel Etyemez, Reza Asari, Gerd Jomrich, George Triadafilopoulos, Kenneth J. Vega, Bruno Zilberstein, Margaret J. Zhou, Qin Huang, Hiroshi Mashimo, Eun Ji Shin, John O. Clark, Sebastian F. Schoppmann

PMC · DOI: 10.1111/nyas.70196 · Annals of the New York Academy of Sciences · 2026-02-06

## TL;DR

This review examines the role of antireflux surgery in preventing esophageal adenocarcinoma, a cancer that often arises from Barrett's esophagus.

## Contribution

The paper provides a critical evaluation of antireflux surgery's potential to prevent Barrett's esophagus from progressing to cancer.

## Key findings

- Antireflux surgery may reduce esophageal adenocarcinoma risk and improve long-term symptom control.
- Evidence remains mixed on whether surgery significantly lowers cancer risk, requiring further research.
- New diagnostic strategies and personalized approaches are emerging for Barrett's esophagus prevention.

## Abstract

Esophageal adenocarcinoma is a major global health concern, primarily arising from gastroesophageal reflux disease, with Barrett's esophagus being its main precursor. Although proton pump inhibitors are commonly used to manage the symptoms from gastroesophageal reflux disease, their role in preventing esophageal adenocarcinoma progression remains uncertain. The aim of this review is to summarize the current advances in the diagnosis of Barrett's esophagus and its progression, as well as to critically evaluate and compare the impact of antireflux surgery on Barrett's esophagus and its potential role in preventing its progression to esophageal adenocarcinoma. In conclusion, surgical intervention, particularly antireflux surgery, has been associated with reduced esophageal adenocarcinoma risk in some studies, offering better long‐term symptom control and possibly preventing cancer progression. However, other authors suggest that the cancer risk does not decrease significantly with surgery, highlighting the need for further investigation into its long‐term preventive benefits. Several novel strategies have been established over the last few years that will facilitate an early diagnosis of Barrett's esophagus in the future.

Esophageal adenocarcinoma (EAC) often develops from gastroesophageal reflux disease (GERD), with Barrett's esophagus (BE) as its main precursor. While proton pump inhibitors manage GERD symptoms, their preventive role in EAC remains unclear. This review summarizes advances in diagnosing BE and evaluates anti‐reflux surgery for its potential to prevent progression. Although evidence is mixed, emerging technologies and personalized approaches are shaping a new standard in BE prevention and treatment.

## Linked entities

- **Diseases:** esophageal adenocarcinoma (MONDO:0005028), gastroesophageal reflux disease (MONDO:0007186), Barrett's esophagus (MONDO:0013662)

## Full-text entities

- **Genes:** LGR5 (leucine rich repeat containing G protein-coupled receptor 5) [NCBI Gene 8549] {aka FEX, GPR49, GPR67, GRP49, HG38}, LEP (leptin) [NCBI Gene 3952] {aka LEPD, OB, OBS}, ADIPOQ (adiponectin, C1Q and collagen domain containing) [NCBI Gene 9370] {aka ACDC, ACRP30, ADIPQTL1, ADPN, APM-1, APM1}, TFF3 (trefoil factor 3) [NCBI Gene 7033] {aka ITF, P1B, TFI}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}
- **Diseases:** esophageal dysmotility (MESH:D015154), tissue (MESH:D017695), dyspepsia (MESH:D004415), Clostridium difficile infection (MESH:D003015), ESCC (MESH:D000077277), Obesity (MESH:D009765), dysplasia (MESH:D015792), mucosal abnormalities (MESH:D052016), heartburn (MESH:D006356), Barrett's and Cancer (MESH:D009369), achalasia (MESH:D004931), dysphagia (MESH:D003680), Metaplasia (MESH:D008679), EGJ dysfunction (MESH:C537006), hernia (MESH:D006547), EAC (MESH:D000230), osteoporosis (MESH:D010024), gastrointestinal (GI) bleeding (MESH:D006471), ARS (MESH:D000267), hiatal hernia (MESH:D006551), gastric cancer (MESH:D013274), laryngitis (MESH:D007827), IM (MESH:D007410), HGD (MESH:D008228), weight loss (MESH:D015431), dysplastic (MESH:D004416), GERD (MESH:D005764), erosive esophagitis (MESH:D004941), chronic cough (MESH:D003371), adiposity (MESH:D018205), chronic kidney disease (MESH:D051436), Barret's esophagus (MESH:D004938), Bile reflux (MESH:D001655), grade dysplasia (MESH:D001254), impaired peristalsis (MESH:D060825), inflammation (MESH:D007249), BE (MESH:D001471), gas bloat syndrome (MESH:C535647), carcinogenesis (MESH:D063646)
- **Chemicals:** omeprazole (MESH:D009853), UDCA (MESH:D014580), ARS (-), acid (MESH:D000143), H&amp;E (MESH:D006371), VOCs (MESH:D055549), bile acid (MESH:D001647), alcohol (MESH:D000438)
- **Species:** Helicobacter pylori (species) [taxon 210], Rattus norvegicus (brown rat, species) [taxon 10116], Homo sapiens (human, species) [taxon 9606], Rodentia (rodent, order) [taxon 9989]

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12880584/full.md

## References

84 references — full list in the complete paper: https://tomesphere.com/paper/PMC12880584/full.md

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Source: https://tomesphere.com/paper/PMC12880584