AI Article Synopsis
- The study aimed to investigate the incidence of esophageal adenocarcinoma (EAC) in Japanese patients with long-segment Barrett's esophagus (BE).
- A multicenter cohort study involved 215 patients, with initial endoscopic examinations and yearly follow-ups; 6 were diagnosed with EAC at enrollment, and an additional 3 developed during follow-up.
- The yearly incidence rate of EAC in these patients was found to be 1.2%, with most initial cases being advanced while follow-up cases were detected at earlier stages allowing for curative treatment.
Article Abstract
Background And Aim: The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively.
Methods: This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed.
Results: Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection.
Conclusions: The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
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| http://dx.doi.org/10.1111/jgh.13491 | DOI Listing |
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- Endoscopic ablation is the primary treatment for dysplastic Barrett's esophagus (BE), primarily utilizing radiofrequency ablation (RFA) and argon plasma coagulation (APC) in Polish medical centers.
- A retrospective analysis of 160 adult patients revealed high rates of complete remission for intestinal metaplasia (80.0%) and dysplasia (93.8%), alongside a manageable adverse event rate, with 30.6% reporting minor and 5.6% major complications.
- The study also identified that RFA, used more for severe cases, had a higher failure rate compared to APC/h-APC, particularly in patients with long-segment BE and diabetes, suggesting specific risk factors for less favorable treatment outcomes
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