Nobuyuki Matsuhashi1, Eiji Sakai1, Ken Ohata1, Norihisa Ishimura2, Junko Fujisaki3, Tomoki Shimizu3, Katsunori Iijima4, Tomoyuki Koike4, Takao Endo5, Takefumi Kikuchi5, Tatsuya Inayoshi6, Yuji Amano7, Takahisa Furuta8, Ken Haruma9, Yoshikazu Kinoshita2. 1. Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan. 2. Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan. 3. Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan. 4. Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. 5. Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan. 6. Sakura Gastroenterology and Digestive Surgery, Susono, Japan. 7. Department of Endoscopy, Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan. 8. Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Japan. 9. Department of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
Abstract
BACKGROUND AND AIM: The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively. METHODS: This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed. RESULTS: Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection. CONCLUSIONS: The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
BACKGROUND AND AIM: The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively. METHODS: This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed. RESULTS: Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection. CONCLUSIONS: The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.