Editor's Note

Article Outline

• Copyright

Readers of this issue of Gastrointestinal Endoscopy will undoubtedly enjoy the landmark study by Overholt et al (Gastrointest Endosc 2005;62:488-98) on porfimer sodium (Photofrin; Axcan Pharma, Mont-Saint-Hilaire, Quebec, Canada) photodynamic therapy (PDT) for the treatment of high-grade dysplasia in patients with Barrett's esophagus. This study provides important information about the natural history of Barrett's high-grade dysplasia and addresses the feasibility and the efficacy of endoscopic mucosal ablation when using porfimer sodium PDT to prevent esophageal cancer development. Apropos of the appearance of this work in the pages of Gastrointestinal Endoscopy, I have done something rather unusual. I have asked two well-known authorities in the field, Drs. Wolfsen and Siersema, to independently prepare editorials arguing “for” and “against” PDT in this disease. Both editorialists were asked to function as trial lawyers in court, bringing forth the best possible arguments in front of the jury of our readers. They were not asked to present their personal opinions. Their views, presented in the following pages, intend to stimulate critical thinking, to stir debate and criticism, and to provide a context for a better understanding of the value of this technology in the current practice of therapeutic endoscopy. I firmly believe that nothing defines a scientific contribution more clearly than its juxtaposition with some form of significant otherness. By doing so, the reader is invited to indulge in the gaps between like and unlike, and pros and cons, and to come out ahead, at least with an understanding that clinical investigation is a conceptual collaboration that crosses continents, practice standards, and personal choices. Reader-critics, indulge, please…