OBJECTIVES: The extent of reduction of esophageal adenocarcinoma (EAC) incidence in Barrett's esophagus (BE) patients after endoscopic ablation is not known. The objective of this study was to determine the cancer incidence in BE patients after ablative therapy and compare these rates to cohort studies of BE patients not undergoing ablation. METHODS: A MEDLINE search of the literature on the natural history and ablative modalities in BE patients was performed. Patients with nondysplastic BE (NDBE), low-grade dysplasia (LGD), or high-grade dysplasia (HGD) and follow-up of at least 6 months were included. The rate of cancer in patients undergoing ablation and from the natural history data was calculated using weighted-average incidence rates (WIR). RESULTS: A total of 53 articles met the inclusion criteria for the natural history data. Pooled natural history data showed cancer incidence of 5.98/1,000 patient-years (95% CI 5.05-6.91) in NDBE; 16.98/1,000 patient-years (95% CI 13.1-20.85) in LGD; and 65.8/1,000 patient-years (95% CI 49.7-81.8) in HGD patients. A total of 65 articles met the inclusion criteria for BE patients undergoing ablation (1,457 patients, NDBE; 239 patients, LGD; and 611 patients, HGD). The WIR for cancer was 1.63/1,000 patient-years (95% CI 0.07-3.34) for NDBE; 1.58/1,000 patient-years (95% CI 0.66-3.84) for LGD; and 16.76/1,000 patient-years (95% CI 10.6-22.9) for HGD patients. CONCLUSIONS: Compared to historical reports of the natural history of BE, ablation may be associated with a reduction in cancer incidence, although such a comparison is limited by likely heterogeneity between treatment and natural history studies. The greatest benefit of ablation was observed in BE patients with HGD.
OBJECTIVES: The extent of reduction of esophageal adenocarcinoma (EAC) incidence in Barrett's esophagus (BE) patients after endoscopic ablation is not known. The objective of this study was to determine the cancer incidence in BE patients after ablative therapy and compare these rates to cohort studies of BE patients not undergoing ablation. METHODS: A MEDLINE search of the literature on the natural history and ablative modalities in BE patients was performed. Patients with nondysplastic BE (NDBE), low-grade dysplasia (LGD), or high-grade dysplasia (HGD) and follow-up of at least 6 months were included. The rate of cancer in patients undergoing ablation and from the natural history data was calculated using weighted-average incidence rates (WIR). RESULTS: A total of 53 articles met the inclusion criteria for the natural history data. Pooled natural history data showed cancer incidence of 5.98/1,000 patient-years (95% CI 5.05-6.91) in NDBE; 16.98/1,000 patient-years (95% CI 13.1-20.85) in LGD; and 65.8/1,000 patient-years (95% CI 49.7-81.8) in HGD patients. A total of 65 articles met the inclusion criteria for BE patients undergoing ablation (1,457 patients, NDBE; 239 patients, LGD; and 611 patients, HGD). The WIR for cancer was 1.63/1,000 patient-years (95% CI 0.07-3.34) for NDBE; 1.58/1,000 patient-years (95% CI 0.66-3.84) for LGD; and 16.76/1,000 patient-years (95% CI 10.6-22.9) for HGD patients. CONCLUSIONS: Compared to historical reports of the natural history of BE, ablation may be associated with a reduction in cancer incidence, although such a comparison is limited by likely heterogeneity between treatment and natural history studies. The greatest benefit of ablation was observed in BE patients with HGD.
Authors: Prateek Sharma; David A Katzka; Neil Gupta; Jaffer Ajani; Navtej Buttar; Amitabh Chak; Douglas Corley; Hashem El-Serag; Gary W Falk; Rebecca Fitzgerald; John Goldblum; Frank Gress; David H Ilson; John M Inadomi; Ernest J Kuipers; John P Lynch; Frank McKeon; David Metz; Pankaj J Pasricha; Oliver Pech; Richard Peek; Jeffrey H Peters; Alessandro Repici; Stefan Seewald; Nicholas J Shaheen; Rhonda F Souza; Stuart J Spechler; Prashanth Vennalaganti; Kenneth Wang Journal: Gastroenterology Date: 2015-08-19 Impact factor: 22.682
Authors: Angelique Levert-Mignon; Michael J Bourke; Sarah J Lord; Andrew C Taylor; Antony R Wettstein; Melanie Edwards; Natalia K Botelho; Rebecca Sonson; Chatura Jayasekera; Oliver M Fisher; Melissa L Thomas; Finlay Macrae; Damian J Hussey; David I Watson; Reginald V Lord Journal: United European Gastroenterol J Date: 2016-07-07 Impact factor: 4.623
Authors: Cathy Bennett; Nimish Vakil; Jacques Bergman; Rebecca Harrison; Robert Odze; Michael Vieth; Scott Sanders; Laura Gay; Oliver Pech; Gaius Longcroft-Wheaton; Yvonne Romero; John Inadomi; Jan Tack; Douglas A Corley; Hendrik Manner; Susi Green; David Al Dulaimi; Haythem Ali; Bill Allum; Mark Anderson; Howard Curtis; Gary Falk; M Brian Fennerty; Grant Fullarton; Kausilia Krishnadath; Stephen J Meltzer; David Armstrong; Robert Ganz; Gianpaolo Cengia; James J Going; John Goldblum; Charles Gordon; Heike Grabsch; Chris Haigh; Michio Hongo; David Johnston; Ricky Forbes-Young; Elaine Kay; Philip Kaye; Toni Lerut; Laurence B Lovat; Lars Lundell; Philip Mairs; Tadakuza Shimoda; Stuart Spechler; Stephen Sontag; Peter Malfertheiner; Iain Murray; Manoj Nanji; David Poller; Krish Ragunath; Jaroslaw Regula; Renzo Cestari; Neil Shepherd; Rajvinder Singh; Hubert J Stein; Nicholas J Talley; Jean-Paul Galmiche; Tony C K Tham; Peter Watson; Lisa Yerian; Massimo Rugge; Thomas W Rice; John Hart; Stuart Gittens; David Hewin; Juergen Hochberger; Peter Kahrilas; Sean Preston; Richard Sampliner; Prateek Sharma; Robert Stuart; Kenneth Wang; Irving Waxman; Chris Abley; Duncan Loft; Ian Penman; Nicholas J Shaheen; Amitabh Chak; Gareth Davies; Lorna Dunn; Yngve Falck-Ytter; John Decaestecker; Pradeep Bhandari; Christian Ell; S Michael Griffin; Stephen Attwood; Hugh Barr; John Allen; Mark K Ferguson; Paul Moayyedi; Janusz A Z Jankowski Journal: Gastroenterology Date: 2012-04-24 Impact factor: 22.682
Authors: Kazuhiro Yasuda; Sung Eun Choi; Norman S Nishioka; David W Rattner; William P Puricelli; Angela C Tramontano; Seigo Kitano; Chin Hur Journal: Dig Dis Sci Date: 2014-01-07 Impact factor: 3.199
Authors: Stuart J Spechler; Prateek Sharma; Rhonda F Souza; John M Inadomi; Nicholas J Shaheen Journal: Gastroenterology Date: 2011-03 Impact factor: 22.682