Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection
| Autor: | Cynthia Rizk, Timothy A. Woodward, Massimo Raimondo, David J. Cangemi, Christianne Wolfsen, Herbert C. Wolfsen, Abraham M. Panossian, Michael B. Wallace, Bashar J. Qumseya |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Neoplasm Residual Esophageal Neoplasms medicine.medical_treatment Kaplan-Meier Estimate Adenocarcinoma Gastroenterology Barrett Esophagus Postoperative Complications Internal medicine Medicine Humans Endoscopic resection Survival rate Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Hepatology business.industry Proportional hazards model Mortality rate Retrospective cohort study Middle Aged medicine.disease Esophagectomy Survival Rate Dysplasia Esophageal Stenosis Female Esophagoscopy Neoplasm Recurrence Local business |
| Zdroj: | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 45(12) |
| ISSN: | 1878-3562 |
| Popis: | Background Endoscopic resection followed by ablative therapy is frequently used to treat esophageal high-grade dysplasia or early esophageal adenocarcinoma. Aims To study outcomes in patients with high-grade dysplasia compared to those with esophageal adenocarcinoma after endoscopic resection. Methods Retrospective, observational, descriptive, single-centre study from a prospective database. We extracted data from 116 endoscopic resections. Survival was plotted using Kaplan–Meier curves multivariable Cox-proportional hazard assess for possible predictors of survival post-endoscopic resection was performed. Results 116 patients (64 esophageal adenocarcinoma, 52 high-grade dysplasia) underwent endoscopic resection from May 2003 to June 2010. Mean age was 71 ± 11 years for high-grade dysplasia and 72 ± 10 years for esophageal adenocarcinoma. Median follow-up was 17 months. Eighty-five patients had negative margins on endoscopic resection. Five-year survivals for high-grade dysplasia and esophageal adenocarcinoma were 86% (range 68–100%) and 78% (59–96%), respectively. Survival was not significantly different between groups (p = 0.20). Overall mortality rate was 10.6% (9/85). At multivariable Cox regression increased Barrett's oesophagus length was associated with worse survival (HR 1.18 [1.06–1.33], p = 0.0039). Survival was not affected by the pathology before resection: HR 2.4 [95%CI, 0.70–8.4], p = 0.16. Conclusions Survival in patients with high-grade dysplasia of the oesophagus is similar to those with esophageal adenocarcinoma. Longer Barrett's oesophagus segments are associated with decreased survival. |
| Databáze: | OpenAIRE |
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