Analysis of metastases rates during follow-up after endoscopic resection of early 'high-risk' esophageal adenocarcinoma

Autor: Esther A. Nieuwenhuis, Sanne N. van Munster, Sybren L. Meijer, Lodewijk A.A. Brosens, Marnix Jansen, Bas L.A. M. Weusten, Lorenza Alvarez Herrero, Alaa Alkhalaf, Ed Schenk, Erik J. Schoon, Wouter L. Curvers, Arjun D. Koch, Steffi E.M. van de Ven, Eva P.D. Verheij, Wouter B. Nagengast, Jessie Westerhof, Martin H.M. G. Houben, Thjon Tang, Jacques J.G. H.M. Bergman, Roos E. Pouw, A. Karrenbeld, A. Ooms, C. Huysentruyt, F. ten Kate, F. Moll, G. Kats-Ugurlu, I. van Lijnschoten, J. van de Laan, J. Offerhaus, K. Biermann, K. Seldenrijk, L. Brosens, S. Meijer, M. Doukas
Přispěvatelé: Gastroenterology & Hepatology, Pathology, Gastroenterology and hepatology, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Interne Geneeskunde, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Nieuwenhuis, E A, van Munster, S N, Meijer, S L, Brosens, L A A, Jansen, M, Weusten, B L A M, Alvarez Herrero, L, Alkhalaf, A, Schenk, E, Schoon, E J, Curvers, W L, Koch, A D, van de Ven, S E M, Verheij, E P D, Nagengast, W B, Westerhof, J, Houben, M H M G, Tang, T, Bergman, J J G H M, Pouw, R E, Dutch Barrett Expert Centers, Karrenbeld, A, Ooms, A, Huysentruyt, C, ten Kate, F, Moll, F, Kats-Ugurlu, G, van Lijnschoten, I, van de Laan, J, Offerhaus, J, Biermann, K, Seldenrijk, K, Brosens, L, Meijer, S & Doukas, M 2022, ' Analysis of metastases rates during follow-up after endoscopic resection of early “high-risk” esophageal adenocarcinoma ', Gastrointestinal Endoscopy, vol. 96, no. 2, pp. 237-247.e3 . https://doi.org/10.1016/j.gie.2022.03.005
Gastrointestinal Endoscopy, 96(2), 237-247.e3. Mosby Inc.
Gastrointestinal endoscopy, 96(2), 237-247.e3. Mosby Inc.
Gastrointestinal endoscopy, 96(2), 237-247.e3. MOSBY-ELSEVIER
Gastrointestinal Endoscopy, 96(2), 237-247.E3. MOSBY-ELSEVIER
ISSN: 0016-5107
DOI: 10.1016/j.gie.2022.03.005
Popis: Background and Aims: After endoscopic resection (ER) of early esophageal adenocarcinoma (EAC), the optimal management of patients with high-risk histologic features for lymph node metastases (ie, submucosal invasion, poor differentiation grade, or lymphovascular invasion) remains unclear. We aimed to evaluate outcomes of endoscopic follow-up after ER for high-risk EAC. Methods: For this retrospective cohort study, data were collected from all Dutch patients managed with endoscopic follow-up (endoscopy, EUS) after ER for high-risk EAC between 2008 and 2019. We distinguished 3 groups: intramucosal cancers with high-risk features, submucosal cancers with low-risk features, and submucosal cancers with high-risk features. The primary outcome was the annual risk for metastases during follow-up, stratified for baseline histology. Results: One hundred twenty patients met the selection criteria. Median follow-up was 29 months (interquartile range, 15-48). Metastases were observed in 5 of 25 (annual risk, 6.9%; 95% confidence interval [CI], 3.0-15) high-risk intramucosal cancers, 1 of 55 (annual risk, .7%; 95% CI, 0-4.0) low-risk submucosal cancers, and 3 of 40 (annual risk, 3.0%; 95% CI, 0-7.0) high-risk submucosal cancers. Conclusions: Whereas the annual metastasis rate for high-risk submucosal EAC (3.0%) was somewhat lower than expected in comparison with previous reported percentages, the annual metastasis rate of 6.9% for high-risk intramucosal EAC is new and worrisome. This calls for further prospective studies and suggests that strict follow-up of this small subgroup is warranted until prospective data are available.
Databáze: OpenAIRE
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