Barrett's esophagus surveillance in a prospective Dutch multi-center community-based cohort of 985 patients demonstrates low risk of neoplastic progression
| Autor: | Bert C. Baak, Sybren L. Meijer, Angela Bureo Gonzalez, Roos E. Pouw, Jacques J. Bergman, Nahid Mostafavi, Lucas C. Duits, Pieter Scholten, Esther Klaver, Arnoud H. Van Oijen, Clarisse Bohmer, Ton Naber, Rosalie C. Mallant-Hent |
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| Přispěvatelé: | Gastroenterology and hepatology, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Graduate School, CCA - Cancer Treatment and Quality of Life, Pathology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms esophageal adenocarcinoma high‐grade dysplasia Adenocarcinoma Risk Assessment Barrett Esophagus Barrett's esophagus Barrett Internal medicine medicine follow-up Humans risk factors Prospective Studies Registries esophageal cancer Esophagus Prospective cohort study Aged Netherlands Proportional Hazards Models follow‐up medicine.diagnostic_test business.industry Gastroenterology Endoscopy Esophageal cancer Middle Aged medicine.disease neoplastic progression high-grade dysplasia medicine.anatomical_structure Oncology Dysplasia Population Surveillance Cohort Disease Progression surveillance Original Article Female business Precancerous Conditions Cohort study malignancy |
| Zdroj: | United European Gastroenterology Journal, 9(8), 929-937. SAGE Publications Inc. United European gastroenterology journal, 9(8), 929-937. SAGE Publications Inc. on behalf of the ReBus Study Group 2021, ' Barrett's esophagus surveillance in a prospective Dutch multi-center community-based cohort of 985 patients demonstrates low risk of neoplastic progression ', United European Gastroenterology Journal, vol. 9, no. 8, pp. 929-937 . https://doi.org/10.1002/ueg2.12114 United European Gastroenterology Journal |
| ISSN: | 2050-6406 |
| DOI: | 10.1002/ueg2.12114 |
| Popis: | Background and Aims Barrett's esophagus (BE) is accompanied by an increased risk of developing esophageal cancer. Accurate risk‐stratification is warranted to improve endoscopic surveillance. Most data available on risk factors is derived from tertiary care centers or from cohorts with limited surveillance time or surveillance quality. The aim of this study was to assess endoscopic and clinical risk factors for progression to high‐grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in a large prospective cohort of BE patients from community hospitals supported by an overarching infrastructure to ensure optimal surveillance quality. Methods A well‐defined prospective multicenter cohort study was initiated in six community hospitals in the Amsterdam region in 2003. BE patients were identified by PALGA search and included in a prospective surveillance program with a single endoscopist performing all endoscopies at each hospital. Planning and data collection was performed by experienced research nurses who attended all endoscopies. Endpoint was progression to HGD/EAC. Results Nine hundred eighty‐five patients were included for analysis. During median follow‐up of 7.9 years (IQR 4.1–12.5) 67 patients were diagnosed with HGD (n = 28) or EAC (n = 39), progression rate 0.78% per patient‐year. As a clinical risk factor age at time of endoscopy was associated with neoplastic progression (HR 1.05; 95% CI 1.03–1.08). Maximum Barrett length and low‐grade dysplasia (LGD) at baseline were endoscopic predictors of progression (HR 1.15; 95% CI 1.09–1.21 and HR 2.36; 95% CI 1.29–4.33). Conclusion Risk of progression to HGD/EAC in a large, prospective, community‐based Barrett's cohort was low. Barrett's length, LGD and age were important risk factors for progression. (www.trialregister.nl NTR1789) |
| Databáze: | OpenAIRE |
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