Pech O et al. – Endoscopic therapy was highly effective and safe, with an excellent long-term survival rate. Risk factors identified may help stratify patients who are at risk for recurrence and those requiring more intensified follow-up. Methods
Data analysis at 5y from a prospective cohort study at an academic tertiary care center (1996 to 2002)
61 pts with HGIN and 288 with BC (173 short-segment; 176 long-segment Barrett’s) from a total of 486 patients presenting with Barrett’s neoplasia; submucosal or more advanced cancers were excluded
Results
Endoscopic resection was performed in 279 pts, photodynamic therapy in 55, and both procedures in 13; 2 pts received argon plasma coagulation
The mean follow-up period was 63.6 ± 23.1 mos
CR was achieved in 337 pts (96.6%); surgery was necessary in 13 (3.7%) after endoscopic therapy failed
Metachronous lesions developed during the follow-up in 74 pts (21.5%); 56 died of concomitant disease, but none died of BC
5y survival rate was 84%
The risk factors most frequently associated with recurrence were piecemeal resection, long-segment Barrett's, no ablative therapy of Barrett's esophagus after CR, time until CR achieved >10 mos and multifocal neoplasia
See all
