TY - JOUR
T1 - Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection
AU - Qumseya, Bashar J.
AU - Panossian, Abraham M.
AU - Rizk, Cynthia
AU - Cangemi, David J.
AU - Wolfsen, Christianne
AU - Raimondo, Massimo
AU - Woodward, Timothy A.
AU - Wallace, Michael B.
AU - Wolfsen, Herbert C.
N1 - Funding Information:
Dr. Wolfsen is a consultant for CSA Medical, Ninepoint Medical, and Oncoscope. He receives research funding from BARRx Medical and Olympus America, Inc. Dr. Wallace is a consultant for Ninepoint Medical. He receives research funding from Olympus America, Inc, American BioOPTICS, and Fujinon.
Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - Background: Endoscopic resection followed by ablative therapy is frequently used to treat esophageal high-grade dysplasia or early esophageal adenocarcinoma. Aims: To study outcomes in patients with high-grade dysplasia compared to those with esophageal adenocarcinoma after endoscopic resection. Methods: Retrospective, observational, descriptive, single-centre study from a prospective database. We extracted data from 116 endoscopic resections. Survival was plotted using Kaplan-Meier curves multivariable Cox-proportional hazard assess for possible predictors of survival post-endoscopic resection was performed. Results: 116 patients (64 esophageal adenocarcinoma, 52 high-grade dysplasia) underwent endoscopic resection from May 2003 to June 2010. Mean age was 71 ± 11 years for high-grade dysplasia and 72 ± 10 years for esophageal adenocarcinoma. Median follow-up was 17 months. Eighty-five patients had negative margins on endoscopic resection. Five-year survivals for high-grade dysplasia and esophageal adenocarcinoma were 86% (range 68-100%) and 78% (59-96%), respectively. Survival was not significantly different between groups (p = 0.20). Overall mortality rate was 10.6% (9/85). At multivariable Cox regression increased Barrett's oesophagus length was associated with worse survival (HR 1.18 [1.06-1.33], p= 0.0039). Survival was not affected by the pathology before resection: HR 2.4 [95%CI, 0.70-8.4], p= 0.16. Conclusions: Survival in patients with high-grade dysplasia of the oesophagus is similar to those with esophageal adenocarcinoma. Longer Barrett's oesophagus segments are associated with decreased survival.
AB - Background: Endoscopic resection followed by ablative therapy is frequently used to treat esophageal high-grade dysplasia or early esophageal adenocarcinoma. Aims: To study outcomes in patients with high-grade dysplasia compared to those with esophageal adenocarcinoma after endoscopic resection. Methods: Retrospective, observational, descriptive, single-centre study from a prospective database. We extracted data from 116 endoscopic resections. Survival was plotted using Kaplan-Meier curves multivariable Cox-proportional hazard assess for possible predictors of survival post-endoscopic resection was performed. Results: 116 patients (64 esophageal adenocarcinoma, 52 high-grade dysplasia) underwent endoscopic resection from May 2003 to June 2010. Mean age was 71 ± 11 years for high-grade dysplasia and 72 ± 10 years for esophageal adenocarcinoma. Median follow-up was 17 months. Eighty-five patients had negative margins on endoscopic resection. Five-year survivals for high-grade dysplasia and esophageal adenocarcinoma were 86% (range 68-100%) and 78% (59-96%), respectively. Survival was not significantly different between groups (p = 0.20). Overall mortality rate was 10.6% (9/85). At multivariable Cox regression increased Barrett's oesophagus length was associated with worse survival (HR 1.18 [1.06-1.33], p= 0.0039). Survival was not affected by the pathology before resection: HR 2.4 [95%CI, 0.70-8.4], p= 0.16. Conclusions: Survival in patients with high-grade dysplasia of the oesophagus is similar to those with esophageal adenocarcinoma. Longer Barrett's oesophagus segments are associated with decreased survival.
KW - Barrett oesophagus
KW - Endoscopic resection
KW - Esophageal adenocarcinoma
KW - Longterm survival
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U2 - 10.1016/j.dld.2013.06.009
DO - 10.1016/j.dld.2013.06.009
M3 - Article
C2 - 23938135
AN - SCOPUS:84887182711
SN - 1590-8658
VL - 45
SP - 1028
EP - 1033
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 12
ER -