Neoplastic Barrett's oesophagus and long-term follow-up after endoscopic therapy: complete histological eradication of Barrett associated with high-grade dysplasia significantly decreases neoplasia relapse.
Details
Serval ID
serval:BIB_74DBC0A2BFB9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neoplastic Barrett's oesophagus and long-term follow-up after endoscopic therapy: complete histological eradication of Barrett associated with high-grade dysplasia significantly decreases neoplasia relapse.
Journal
Surgical endoscopy
ISSN
1432-2218 (Electronic)
ISSN-L
0930-2794
Publication state
Published
Issued date
12/2016
Peer-reviewed
Oui
Volume
30
Number
12
Pages
5410-5418
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Endotherapy (ET) has replaced surgery as the first-line treatment of high-grade dysplasia (HGD)/superficial ECA (ECAs) from Barrett's oesophagus (BO). However, long-term follow-up and predictive factors of relapse are not so well studied. The aim of the following study was to evaluate the efficiency of ET for treatment of HGD/ECAs and to determine factors of long-term efficiency.
ET procedures were manually reported and registered in a hospital data base from March 2000 to July 2010. Inclusion criteria were HGD/ECA on pre-resection biopsies, complete histological and sufficient oncological resection of HGD/ECAs, and complete macroscopic resection of metaplastic BO. Sixty patients (53 men, mean age = 65 years) were included.
Median follow-up was 66 months [range 42-80]. Complete eradication of residual histological metaplastic BO occurred in 29 patients (48 %). Relapse rate at 36 months was 16.6 % (n = 10) and was unchanged at 60 months of follow-up. There was only one relapse (3.4 %) in case of complete eradication of metaplastic BO and 9 (31 %) in case of incomplete eradication. In univaried and multi-varied analysis, complete eradication of metaplastic BO (p < 0.05) and BO length <5 cm (p < 0.05) were predictive of neoplastic BO non relapse. The length of BO remained a prognostic factor for disease-free survival (DFS). When these preponderant data were cancelled out in multi-varied analysis, complete eradication of BO was a prognostic factor for DFS (p < 0.05).
Complete histological eradication of BO by ET significantly decreases the rate of neoplasia relapse.
ET procedures were manually reported and registered in a hospital data base from March 2000 to July 2010. Inclusion criteria were HGD/ECA on pre-resection biopsies, complete histological and sufficient oncological resection of HGD/ECAs, and complete macroscopic resection of metaplastic BO. Sixty patients (53 men, mean age = 65 years) were included.
Median follow-up was 66 months [range 42-80]. Complete eradication of residual histological metaplastic BO occurred in 29 patients (48 %). Relapse rate at 36 months was 16.6 % (n = 10) and was unchanged at 60 months of follow-up. There was only one relapse (3.4 %) in case of complete eradication of metaplastic BO and 9 (31 %) in case of incomplete eradication. In univaried and multi-varied analysis, complete eradication of metaplastic BO (p < 0.05) and BO length <5 cm (p < 0.05) were predictive of neoplastic BO non relapse. The length of BO remained a prognostic factor for disease-free survival (DFS). When these preponderant data were cancelled out in multi-varied analysis, complete eradication of BO was a prognostic factor for DFS (p < 0.05).
Complete histological eradication of BO by ET significantly decreases the rate of neoplasia relapse.
Keywords
Adult, Aged, Barrett Esophagus/pathology, Barrett Esophagus/surgery, Biopsy, Disease-Free Survival, Esophageal Neoplasms/pathology, Esophageal Neoplasms/surgery, Esophagoscopy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local/pathology, Neoplasm Recurrence, Local/prevention & control, Precancerous Conditions/pathology, Precancerous Conditions/surgery, Prognosis, Retrospective Studies, Treatment Outcome, Barrett’s oesophagus, DHG, ECA, Endoscopic resection, Follow-up
Pubmed
Web of science
Create date
07/10/2019 15:34
Last modification date
01/11/2019 7:26