3. Secondary outcomes.

Study	Cancer‐free survival		Treatment failures		Procedure‐related mortality (30 day)		Complications		QoL
Treatment group	Endoscopic treatment	Surgical treatment	Endoscopic treatment	Surgical treatment	Endoscopic treatment	Surgical treatment	Endoscopic treatment	Surgical treatment	Endoscopic treatment	Surgical treatment
Pacifico 2003	83% (20/24) remained free of cancer at 12 ± 2 and 19 ± 3 months	All patients remained free of cancer at 12 ± 2 and 19 ± 3 months	Persistent cancer at first follow‐up 17% (4/24 patients). No later recurrence	None	None	2%	Stricture: 8% Photo‐ sensitivity: 8%	Stricture: 16% Anastomotic leak: 8% Wound infection: 8% Dumping syndrome: 5% Empyema (pus in the pleural cavity): 3% Blood transfusion: 3% Atrial fibrillation: 3% Aspiration: 2% Chylothorax (lymphatic effusion in the pleural cavity): 2%	Not reported
Prasad 2007	No significant difference between groups but tendency towards lower cancer‐free survival in endoscopic therapy group	HGD eliminated: at 1 year: 88%; at 3 years: 86% HGD detected within 12 months: 26% (33/129) i.e. failed initial therapy and retreated, HGD eradicated in 70% of these. Recurrence of HGD (detected after 12 months free of HGD): 7.8% (10/129) Cancer detected during follow‐up (up to 18 months after PDT): 6.2% (8/129)	None	None	1.4%	No early complications Stricture formation: 27% Photosensitivity: 60%	38% Postoperative morbidity Stricture formation: 12.6%	No QoL data, performance score only given ECOG PS?1 in 73% at end of FU* Proportions unchanged from pre‐therapy	No QoL data, performance score only given ECOG PS?1 in 94% at end of FU* Proportions unchanged from pre‐therapy
Das 2008	(Only oesophageal cancer‐specific cause of death considered) 56 months (50 to 61 months)	59 months (57 to 67 months) (no significant difference)	Not reported	Not reported	Not reported	Not reported
Reed 2005	Not reported	5/42 PDT and 2/5 EMR patients had recurrent HGD/cancer after mean 13.5 months. 1 developed metastatic spread but 0 died during follow‐up	3/49 patients died from recurrent disease	Not reported	2% (cerebrovascular accident in postoperative period)	Not reported	Anastomotic leaks: 4%	Not reported
Rosmolen 2010	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Significant bleeding: 3%, perforation: 2%, oesophageal stenosis: 31%	Symptomatic anastomotic leakage: 15 %, pulmonary problems: 30 %, serious infections: 15 % and vocal cord paralysis: 15 %. Anastomotic stenosis in 37% during follow‐up	QoL measured (SF‐36, EORTC‐QLQ‐C30, EORTC‐QLQ‐OES18 questionnaires). HADS, WOCS. Endoscopy patients reported more fear of recurrence on the WOCS than surgery patients (P = 0.003). No significant differences were found between the 2 groups on the other outcomes	Surgery patients had significantly more eating problems (OR 18.3; P < 0.001) and reflux symptoms (OR 3.4; P = 0.05) on the EORTC‐OES18 questionnaire
Schembre 2008	Not reported	Residual Barrett's segment in 44%, persistent dysplasia in 13%, progression to cancer in 6%	Residual Barrett's segment in 3%, persistent dysplasia in 3%, no progression to cancer	2%: 1 patient died from diverticulitis	None	Major: 8% Minor: 32%	Major: 13% Minor: 66% (significantly different)	Not reported	‐	‐
Yachimski 2008	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported
Farrell 2011	Not reported	Not reported	In patients treated by EMR + RFA, there was 100% disease control; 72% had complete eradication of Barrett's disease, and 1 patient represented with low‐grade dysplasia	4.8% surgical patients relapsed with HGD or cancer and 1 patient with T1N1 disease died of recurrent disease	Unclear from study report	Unclear from study report	2% mortality and 32% morbidity	2% morbidity from EMR + RFA (statistically significant compared with surgery P=0.001)	Not reported	Not reported
Pech 2011	98.7% at 4.1 years	100% at 3.7 years	6.6% (repeat endoscopic treatment was successful in all patients who experienced disease recurrence	No deaths from tumour‐related disease during follow‐up	None	Mortality at 40 days 2.6%	Minor complication in 17% (bleeding managed by clipping or injection). No major complications (severe bleeding, perforation stenosis) observed	32% major complications. including anastomotic leakage, pneumonia, multiple organ failure following sepsis, cardiac problems	Not reported	Not reported
Schembre 2010	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	SF‐36: no significant differences compared with surgery GIQLI: higher (better) scores among ASA Class 1 and 2 endotherapy patients compared with surgery (not statistically significant) and higher among young endotherapy patients than young surgery patients	SF‐36: no significant differences other than superior physical functioning in patients 65 years of age and older GIQLI: no significant differences in scores of older patients for surgery and endotherapy or SAS 3 patients. Negative QoL impact appears to be greater for younger patients undergoing surgery. (overall QoL scores: "QOL scores among EG and ET groups were not significantly different than sex age‐matched controls”
Tian 2011	Not reported	Not reported	In group who had EMR as only therapy, 21.4% had cancer recurrence at 45 months follow‐up (remaining 11 had mean cancer‐free periods of 21 months)	Not reported	None	1 death at 34 days owing to anastomotic leak (with 'do not resuscitate' order)	Not reported	Not reported	Not reported	Not reported
Thomas 2005	Not reported	Not reported	2/5 went on to develop metastatic adenocarcinoma at 9 and 12 months follow‐up	2/8 patients developed recurrent adenocarcinoma at 22 and 60 months after surgery, 1 of whom died	None	None	Postoperative morbidity in 4 patients (pneumonia, adult respiratory distress syndrome, pneumothorax) 2/8 developed postoperative strictures at 3 to 6 months' postsurgery requiring ongoing dilation	Not reported	Not reported	Not reported
Zehetner 2011	100% at 3 years; 100% at 5 years	100% at 3 years; 88% at 5 years	20% had new or metachronous cancer	None	None	None	None reported	39% had complications including long‐term complications of anastomotic strictures, ventral hernias, reflux, postprandial dumping or diarrhoea	Not reported	Not reported

*ECOG PS 0 = fully active, able to carry on all pre‐disease performance without restriction.

ECOG PS 1 = restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work.

ASA: American Society of Anesthesia; EMR: endoscopic mucosal resection; EORTC‐QLQ: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; FU: fluorouracil; GIQLI: Gastrointestinal Quality of Life Index; HADS: Hospital Anxiety and Depression Scale; OR: odds ratio; PDT: photodynamic therapy; QoL: quality of life; RFA: radiofrequency ablation; SF‐36: 36‐item Short Form; WOCS: Worry Of Cancer Scale.