Incidence and Predictors of Adenocarcinoma Following Endoscopic Ablation of Barrett’s Esophagus

Background The rate and risk factors of recurrent or metachronous adenocarcinoma following endoscopic ablation therapy in patients with Barrett’s esophagus (BE) have not been specifically reported. Aim The aim of this study was to determine the incidence and predictors of adenocarcinoma after ablati...

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Veröffentlicht in:Digestive diseases and sciences 2014-07, Vol.59 (7), p.1560-1566
Hauptverfasser: Yasuda, Kazuhiro, Choi, Sung Eun, Nishioka, Norman S., Rattner, David W., Puricelli, William P., Tramontano, Angela C., Kitano, Seigo, Hur, Chin
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container_end_page 1566
container_issue 7
container_start_page 1560
container_title Digestive diseases and sciences
container_volume 59
creator Yasuda, Kazuhiro
Choi, Sung Eun
Nishioka, Norman S.
Rattner, David W.
Puricelli, William P.
Tramontano, Angela C.
Kitano, Seigo
Hur, Chin
description Background The rate and risk factors of recurrent or metachronous adenocarcinoma following endoscopic ablation therapy in patients with Barrett’s esophagus (BE) have not been specifically reported. Aim The aim of this study was to determine the incidence and predictors of adenocarcinoma after ablation therapy for BE high-grade dysplasia (HGD) or intramucosal carcinoma (IMC). Methods This is a single center, retrospective review of prospectively collected data on consecutive cases of endoscopic ablation for BE. A total of 223 patients with BE (HGD or IMC) were treated by ablation between 1996 and 2011. Primary outcome measures were recurrence and new development of adenocarcinoma after ablation. Recurrence was defined as the presence of adenocarcinoma following the absence of adenocarcinoma in biopsy samples from two consecutive surveillance endoscopies. Logistic regression analysis was performed to assess predictors of adenocarcinoma after ablation. Results One hundred and eighty-three patients were included in the final analysis, and 40 patients were excluded: 22 for palliative ablation, eight lost to follow-up, five for residual carcinoma and five for postoperative state. Median follow-up was 39 months. Recurrence or new development of adenocarcinoma was found in 20 patients (11 %) and the median time to recurrence/development of adenocarcinoma was 11.5 months. Independent predictors of recurrent or metachronous adenocarcinoma were hiatal hernia size ≥ 4 cm (odds ratio 3.649, P  = 0.0233) and histology (HGD/adenocarcinoma) after first ablation (odds ratio 4.141, P  = 0.0065). Conclusions Adenocarcinoma after endoscopic therapy for HGD or IMC in BE is associated with large hiatal hernia and histology status after initial ablation therapy.
doi_str_mv 10.1007/s10620-013-3002-5
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Aim The aim of this study was to determine the incidence and predictors of adenocarcinoma after ablation therapy for BE high-grade dysplasia (HGD) or intramucosal carcinoma (IMC). Methods This is a single center, retrospective review of prospectively collected data on consecutive cases of endoscopic ablation for BE. A total of 223 patients with BE (HGD or IMC) were treated by ablation between 1996 and 2011. Primary outcome measures were recurrence and new development of adenocarcinoma after ablation. Recurrence was defined as the presence of adenocarcinoma following the absence of adenocarcinoma in biopsy samples from two consecutive surveillance endoscopies. Logistic regression analysis was performed to assess predictors of adenocarcinoma after ablation. Results One hundred and eighty-three patients were included in the final analysis, and 40 patients were excluded: 22 for palliative ablation, eight lost to follow-up, five for residual carcinoma and five for postoperative state. Median follow-up was 39 months. Recurrence or new development of adenocarcinoma was found in 20 patients (11 %) and the median time to recurrence/development of adenocarcinoma was 11.5 months. Independent predictors of recurrent or metachronous adenocarcinoma were hiatal hernia size ≥ 4 cm (odds ratio 3.649, P  = 0.0233) and histology (HGD/adenocarcinoma) after first ablation (odds ratio 4.141, P  = 0.0065). Conclusions Adenocarcinoma after endoscopic therapy for HGD or IMC in BE is associated with large hiatal hernia and histology status after initial ablation therapy.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-013-3002-5</identifier><identifier>PMID: 24395382</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Ablation (Surgery) ; Adenocarcinoma ; Adenocarcinoma - epidemiology ; Adenocarcinoma - etiology ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Barrett Esophagus - pathology ; Barrett Esophagus - surgery ; Biochemistry ; Care and treatment ; Catheter Ablation ; Development and progression ; Dysplasia ; Endoscopy ; Esophageal Neoplasms - epidemiology ; Esophageal Neoplasms - etiology ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - surgery ; Esophagoscopy ; Female ; Follow-Up Studies ; Gastroenterology ; Hepatology ; Hernia ; Hernia, Hiatal - complications ; Humans ; Incidence ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neoplasm Recurrence, Local ; Oncology ; Original Article ; Pneumoviridae ; Precancerous Conditions - pathology ; Precancerous Conditions - surgery ; Retrospective Studies ; Risk Factors ; Transplant Surgery ; Treatment Outcome</subject><ispartof>Digestive diseases and sciences, 2014-07, Vol.59 (7), p.1560-1566</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>COPYRIGHT 2014 Springer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c640t-fc245b6e020de8301daa3e54a5e75c7191c0f114a3cd18300cb2bbcd48e363b03</citedby><cites>FETCH-LOGICAL-c640t-fc245b6e020de8301daa3e54a5e75c7191c0f114a3cd18300cb2bbcd48e363b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-013-3002-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-013-3002-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24395382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yasuda, Kazuhiro</creatorcontrib><creatorcontrib>Choi, Sung Eun</creatorcontrib><creatorcontrib>Nishioka, Norman S.</creatorcontrib><creatorcontrib>Rattner, David W.</creatorcontrib><creatorcontrib>Puricelli, William P.</creatorcontrib><creatorcontrib>Tramontano, Angela C.</creatorcontrib><creatorcontrib>Kitano, Seigo</creatorcontrib><creatorcontrib>Hur, Chin</creatorcontrib><title>Incidence and Predictors of Adenocarcinoma Following Endoscopic Ablation of Barrett’s Esophagus</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background The rate and risk factors of recurrent or metachronous adenocarcinoma following endoscopic ablation therapy in patients with Barrett’s esophagus (BE) have not been specifically reported. Aim The aim of this study was to determine the incidence and predictors of adenocarcinoma after ablation therapy for BE high-grade dysplasia (HGD) or intramucosal carcinoma (IMC). Methods This is a single center, retrospective review of prospectively collected data on consecutive cases of endoscopic ablation for BE. A total of 223 patients with BE (HGD or IMC) were treated by ablation between 1996 and 2011. Primary outcome measures were recurrence and new development of adenocarcinoma after ablation. Recurrence was defined as the presence of adenocarcinoma following the absence of adenocarcinoma in biopsy samples from two consecutive surveillance endoscopies. Logistic regression analysis was performed to assess predictors of adenocarcinoma after ablation. Results One hundred and eighty-three patients were included in the final analysis, and 40 patients were excluded: 22 for palliative ablation, eight lost to follow-up, five for residual carcinoma and five for postoperative state. Median follow-up was 39 months. Recurrence or new development of adenocarcinoma was found in 20 patients (11 %) and the median time to recurrence/development of adenocarcinoma was 11.5 months. Independent predictors of recurrent or metachronous adenocarcinoma were hiatal hernia size ≥ 4 cm (odds ratio 3.649, P  = 0.0233) and histology (HGD/adenocarcinoma) after first ablation (odds ratio 4.141, P  = 0.0065). Conclusions Adenocarcinoma after endoscopic therapy for HGD or IMC in BE is associated with large hiatal hernia and histology status after initial ablation therapy.</description><subject>Ablation (Surgery)</subject><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - etiology</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Barrett Esophagus - pathology</subject><subject>Barrett Esophagus - surgery</subject><subject>Biochemistry</subject><subject>Care and treatment</subject><subject>Catheter Ablation</subject><subject>Development and progression</subject><subject>Dysplasia</subject><subject>Endoscopy</subject><subject>Esophageal Neoplasms - epidemiology</subject><subject>Esophageal Neoplasms - etiology</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagoscopy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Hernia</subject><subject>Hernia, Hiatal - complications</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pneumoviridae</subject><subject>Precancerous Conditions - pathology</subject><subject>Precancerous Conditions - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFks1u1DAUhS0EokPhAdigSGzYpNzrn_xskIZqCpUqwQLWlmM7qavEHuykiF1fo6_Hk-DRlGqKQMgLWznfOY6vDiEvEU4QoH6bECoKJSArGQAtxSOyQlGzkoqqeUxWgFU-I1ZH5FlKVwDQ1lg9JUeUs1awhq6IOvfaGeu1LZQ3xedojdNziKkIfbHOQtAqaufDpIqzMI7hu_NDsfEmJB22ThfrblSzC37Hv1cx2nn-eXObik0K20s1LOk5edKrMdkXd_sx-Xq2-XL6sbz49OH8dH1R6orDXPaactFVFigY2zBAoxSzgitha6FrbFFDj8gV0wazDrqjXacNbyyrWAfsmLzb526XbrJGWz9HNcptdJOKP2RQTj5UvLuUQ7iWHGpErHPAm7uAGL4tNs1ycknbcVTehiVJbDmlWNGm_T8qOCDFlrGMvv4DvQpL9HkSmWIta1oQB9SgRiud70P-Rb0Llesaab6ZsyZTJ3-h8jJ2cjp427v8_YEB9wYdQ0rR9vfjQJC7Csl9hWSukNxVSIrseXU4x3vH785kgO6BlCU_2Hjwon-m_gILk9D0</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Yasuda, Kazuhiro</creator><creator>Choi, Sung Eun</creator><creator>Nishioka, Norman S.</creator><creator>Rattner, David W.</creator><creator>Puricelli, William P.</creator><creator>Tramontano, Angela C.</creator><creator>Kitano, Seigo</creator><creator>Hur, Chin</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20140701</creationdate><title>Incidence and Predictors of Adenocarcinoma Following Endoscopic Ablation of Barrett’s Esophagus</title><author>Yasuda, Kazuhiro ; 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Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pneumoviridae</topic><topic>Precancerous Conditions - pathology</topic><topic>Precancerous Conditions - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yasuda, Kazuhiro</creatorcontrib><creatorcontrib>Choi, Sung Eun</creatorcontrib><creatorcontrib>Nishioka, Norman S.</creatorcontrib><creatorcontrib>Rattner, David W.</creatorcontrib><creatorcontrib>Puricelli, William P.</creatorcontrib><creatorcontrib>Tramontano, Angela C.</creatorcontrib><creatorcontrib>Kitano, Seigo</creatorcontrib><creatorcontrib>Hur, Chin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Aim The aim of this study was to determine the incidence and predictors of adenocarcinoma after ablation therapy for BE high-grade dysplasia (HGD) or intramucosal carcinoma (IMC). Methods This is a single center, retrospective review of prospectively collected data on consecutive cases of endoscopic ablation for BE. A total of 223 patients with BE (HGD or IMC) were treated by ablation between 1996 and 2011. Primary outcome measures were recurrence and new development of adenocarcinoma after ablation. Recurrence was defined as the presence of adenocarcinoma following the absence of adenocarcinoma in biopsy samples from two consecutive surveillance endoscopies. Logistic regression analysis was performed to assess predictors of adenocarcinoma after ablation. Results One hundred and eighty-three patients were included in the final analysis, and 40 patients were excluded: 22 for palliative ablation, eight lost to follow-up, five for residual carcinoma and five for postoperative state. Median follow-up was 39 months. Recurrence or new development of adenocarcinoma was found in 20 patients (11 %) and the median time to recurrence/development of adenocarcinoma was 11.5 months. Independent predictors of recurrent or metachronous adenocarcinoma were hiatal hernia size ≥ 4 cm (odds ratio 3.649, P  = 0.0233) and histology (HGD/adenocarcinoma) after first ablation (odds ratio 4.141, P  = 0.0065). Conclusions Adenocarcinoma after endoscopic therapy for HGD or IMC in BE is associated with large hiatal hernia and histology status after initial ablation therapy.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24395382</pmid><doi>10.1007/s10620-013-3002-5</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Ablation (Surgery)
Adenocarcinoma
Adenocarcinoma - epidemiology
Adenocarcinoma - etiology
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Barrett Esophagus - pathology
Barrett Esophagus - surgery
Biochemistry
Care and treatment
Catheter Ablation
Development and progression
Dysplasia
Endoscopy
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - etiology
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagoscopy
Female
Follow-Up Studies
Gastroenterology
Hepatology
Hernia
Hernia, Hiatal - complications
Humans
Incidence
Kaplan-Meier Estimate
Logistic Models
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local
Oncology
Original Article
Pneumoviridae
Precancerous Conditions - pathology
Precancerous Conditions - surgery
Retrospective Studies
Risk Factors
Transplant Surgery
Treatment Outcome
title Incidence and Predictors of Adenocarcinoma Following Endoscopic Ablation of Barrett’s Esophagus
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