Long‐term endoscopic surveillance for Barrett's esophagus in Japan: Multicenter prospective cohort study
Autor: | Yasuhiko Abe, Reiko Ami, Atsushi Masamune, Naohiro Dairaku, Motoki Ohyauchi, Hirohiko Shinkai, Shuichi Ohara, Katsunori Iijima, Fumitake Ishiyama, Yoshifumi Inomata, Tatsuya Hoshi, Kenta Watanabe, Shoichi Kayaba, Masahiro Saito, Yosuke Shimodaira, Hirotaka Ito, Tomoyuki Koike, Tooru Shimosegawa, Sho Asonuma, Katsuaki Kato, Tomoyuki Oikawa, Kazuaki Norita |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Esophageal Neoplasms Gastroenterology Cohort Studies Barrett Esophagus 03 medical and health sciences 0302 clinical medicine Japan Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Esophagus Prospective cohort study medicine.diagnostic_test business.industry Incidence (epidemiology) Intestinal metaplasia medicine.disease Confidence interval Endoscopy medicine.anatomical_structure 030220 oncology & carcinogenesis Barrett's esophagus Cohort 030211 gastroenterology & hepatology Esophagoscopy business Follow-Up Studies |
Zdroj: | Digestive Endoscopy. 33:1085-1092 |
ISSN: | 1443-1661 0915-5635 |
Popis: | Objects Although a recent study showed the cancer incidence of Barrett's esophagus (BE) to be 1.2%/year in 251 patient-years in Japan, the long-term outcomes remain unclear. The present study estimated the cancer risk of BE in Japan using our original prospective multicenter cohort. Methods A total of 98 patients with BE of maximum length of ≥2 cm were enrolled during the period of 2010 to 2012 and received at least 1 follow-up endoscopy over 5 years thereafter. Cancer incidence rates with 95% confidence interval for occurrence of esophageal adenocarcinoma were calculated as the number of events divided by patient-years of follow-up and were expressed as %/year. Results Overall, the median endoscopic follow-up period was 59.9 (first and third quartiles: 48.5-60.8) months, constituting a total of 427 patient-years of observation. Since 2 esophageal adenocarcinoma cases developed, the cancer incidence was 0.47% (0.01%-1.81%)/year. The cancer incidence was 0.39% (-0.16%-2.44%) in 232 patient-years and 0.31% (-0.13%-1.95%)/year in 318 patient-years for 55 cases with specialized intestinal metaplasia and 70 with BE ≥3 cm (maximum), respectively. At the end of follow-up, 12 of 92 patients (13.0%) died, but none died from esophageal adenocarcinoma. Conclusion This is the largest prospective follow-up study with endoscopy to investigate the incidence of esophageal adenocarcinoma in unequivocal BE with the maximum length of ≥2 cm in Japan. Although a further large-scale study will be required to validate our results, the cancer risk of BE in Japan would be lower than previously reported (0.47% vs. 1.2%/year). |
Databáze: | OpenAIRE |
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