Clinical Relevance of Random Biopsies From the Esophagogastric Junction After Complete Eradication of Barrett's Esophagus is Low

Autor: Charlotte N. Frederiks, Sanne N. van Munster, Esther A. Nieuwenhuis, Lorenza Alvarez Herrero, Alaa Alkhalaf, Boudewijn E. Schenk, Erik J. Schoon, Wouter L. Curvers, Arjun D. Koch, Pieter-Jan F. de Jonge, Thjon Tang, Wouter B. Nagengast, Jessie Westerhof, Martin H.M.G. Houben, Jacques J.G.H.M. Bergman, Roos E. Pouw, Bas L.A.M. Weusten
Přispěvatelé: Gastroenterology and hepatology, CCA - Cancer Treatment and quality of life, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, Gastroenterology & Hepatology
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Clinical Gastroenterology and Hepatology. W.B. Saunders Ltd
Dutch Barrett Expert Centers 2023, ' Clinical Relevance of Random Biopsies From the Esophagogastric Junction After Complete Eradication of Barrett's Esophagus is Low ', Clinical Gastroenterology and Hepatology, vol. 21, no. 9, pp. 2260-2269.e9 . https://doi.org/10.1016/j.cgh.2022.11.012, https://doi.org/10.1016/j.cgh.2022.11.012
Clinical gastroenterology and hepatology. W.B. Saunders Ltd
Clinical Gastroenterology and Hepatology. W.B. Saunders
ISSN: 1542-7714
1542-3565
DOI: 10.1016/j.cgh.2022.11.012
Popis: Background & Aims: Although random histological sampling from the esophagogastric junction (EGJ) after complete eradication of Barrett's esophagus (BE) is recommended, its clinical relevance is questionable. This study aimed to assess the incidence and long-term outcomes of findings from random EGJ biopsies in a nationwide cohort with long-term follow-up. Methods: We included all patients with successful endoscopic eradication therapy (EET), defined as complete endoscopic eradication of all visible BE (CE-BE), for early BE neoplasia from the Dutch registry. Patients were treated and followed-up in 9 expert centers according to a joint protocol. Outcomes included the incidence of intestinal metaplasia (IM) at the EGJ (EGJ-IM) and the association between IM and visible (dysplastic) BE recurrence. Results: A total of 1154 patients were included with a median follow-up of 43 months (interquartile range, 22–69 months). At the time of CE-BE, persisting EGJ-IM was found in 7% of patients (78/1154), which was reproduced during further follow-up in 46% of patients (42/78). No significant association existed between persisting EGJ-IM at CE-BE and recurrent non-dysplastic or dysplastic BE (hazard ratio [HR], 1.15; 95% confidence interval [CI], 0.63–2.13 and HR, 0.73; 95% CI, 0.17-3.06, respectively). Among patients with no EGJ-IM at the time of CE-BE (1043/1154; 90%), EGJ-IM recurred in 7% (72/1043) after a median of 21 months (interquartile range, 15–36 months), and was reproduced during further follow-up in 26% of patients (19/72). No association was found between recurrent EGJ-IM and non-dysplastic or dysplastic recurrence (HR, 1.18; 95% CI, 0.67–2.06 and HR, 0.27; 95% CI, 0.04–1.96, respectively). Conclusion: Because EGJ-IM was not associated with a higher risk for recurrent disease, we recommend to consider abandoning random EGJ sampling after successful EET, under the condition that care is provided in expert centers, and the esophagus, including the EGJ, is carefully inspected (Netherlands Trial Register, NL7309).
Databáze: OpenAIRE
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