Successful endoscopic treatment of intraductal extension of a villous adenoma with high-grade dysplasia, with 3-year follow-up

2011 ◽  
Vol 74 (3) ◽  
pp. 714-716 ◽  
Author(s):  
Atif Saleem ◽  
Kenneth K. Wang ◽  
Todd H. Baron
Keyword(s):  
Endoscopic Treatment ◽  
Villous Adenoma ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Intraductal Extension

Endoscopic Surveillance Practice for Barrett's Oesophagus in Scotland and Early Experience in Implementing Local Guidelines

2003 ◽  
Vol 48 (2) ◽  
pp. 43-45 ◽  
Author(s):  
E F Shen ◽  
S Gladstone ◽  
G Milne ◽  
S Paterson-Brown ◽  
I D Penman
Keyword(s):  
Early Experience ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Wide Variability ◽  
Low Grade Dysplasia ◽  
Surveillance Practice ◽  
Four Quadrant ◽  
The Impact

Management of columnar lined oesophagus (CLO; Barrett s oesophagus) is controversial. We prospectively audited surveillance practices in Scotland and prospectively assessed the impact of introducing local guidelines for Barrett s surveillance in Edinburgh. Most respondents were gastroenterologists. The majority take random, not four quadrant, biopsies from the CLO. In Edinburgh during 2000, 80 patients underwent surveillance. The guideline protocol was not followed in 30 (37.5%) patients. Follow up of patients without dysplasia generally conformed to the guidelines. Follow up of patients with low grade dysplasia was highly variable while management of those with high grade dysplasia followed the guidelines. Overall we found a wide variability in the management and surveillance of CLO. Early experience suggests that implementation of guidelines is helpful but there is still variation in practice.

Risk of High-Grade Dysplasia and Cancer at Follow-up After Colorectal Endoscopic Mucosal Resection (EMR)

2015 ◽  
Vol 110 ◽  
pp. S583
Author(s):  
Bhaumik Brahmbhatt ◽  
Abhishek Bhurwal ◽  
Michael Bartel ◽  
Jose Melendez ◽  
Massimo Raimondo ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Mucosal Resection

Long-term follow-up of patients with Barrett esophagus: Progression to high-grade dysplasia and esophageal adenocarcinoma according to histology at presentation.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 20-20 ◽  
Author(s):  
Allon Kahn ◽  
Vishnu Kommineni ◽  
Jonathan Callaway ◽  
Rahul Pannala ◽  
David Fleischer ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Large Cohort ◽  
High Grade Dysplasia ◽  
Continuous Treatment ◽  
Barrett Esophagus ◽  
Low Grade ◽  
High Grade ◽  
Upper Endoscopy ◽  
Early Stage Disease

20 Background: Esophageal adenocarcinoma (EAC) incidence is rising and prognosis is uniformly poor, even with early stage disease. Barrett esophagus (BE) serves as a premalignant marker for EAC, with an estimated progression of 0.5% per year. Low-grade (LGD) and high-grade dysplasia (HGD) confer a higher risk of progression, providing an opportunity for intervention and surveillance. Aims: To evaluate a large cohort of patients undergoing endoscopic evaluation of BE and thereby better understand the natural history of BE and dysplasia. Methods: A retrospective review of endoscopic databases was conducted for all patients with the diagnosis of BE undergoing upper endoscopy at a tertiary academic medical center from 1991-2010. All endoscopy and accompanying pathology reports were reviewed. Only those patients with 2 biopsies documenting specialized intestinal metaplasia were analyzed. Results: 848 patients underwent upper endoscopy for evaluation of BE. Of these, 674 patients met inclusion criteria, at a mean follow up of 66.6 months. Table 1 depicts the distribution of patients according to their histology at presentation. 22 (3.2%) patients presented with established EAC, while EAC developed in 51 (7.6%). Of patients with HGD, LGD, or no dysplasia (ND) at presentation, EAC ultimately developed in 30.6%, 6.6%, and 2.7%, respectively. EAC developed in 4 patients despite RFA treatment for ND (2) or LGD (2). HGD developed in 6 such patients after treatment for ND (3) and LGD (3). Only 1 patient in each RFA-treated cohort required esophagectomy, while the others cleared dysplasia or EAC with continuous treatment. Conclusions: In this large cohort of patients with Barrett’s esophagus, higher grade of dysplasia at first endoscopy was associated with development of EAC. Continuous surveillance during and after endoscopic treatment is necessary and often results in clearance of dysplasia and EAC. [Table: see text]

Comparative Effectiveness of Esophagectomy Versus Endoscopic Treatment for Esophageal High-grade Dysplasia

2016 ◽  
Vol 263 (4) ◽  
pp. 719-726 ◽  
Author(s):  
Yinin Hu ◽  
Varun Puri ◽  
Vanessa M. Shami ◽  
George J. Stukenborg ◽  
Benjamin D. Kozower
Keyword(s):  
Endoscopic Treatment ◽  
Comparative Effectiveness ◽  
High Grade Dysplasia ◽  
High Grade

scholarly journals A case of urachal villous adenoma with high grade dysplasia focally bordering on adenocarcinoma in situ

2018 ◽  
Vol 16 ◽  
pp. 25-28
Author(s):  
Sriharsha Talluri ◽  
Waleed Eisa ◽  
Renee Frank ◽  
Heinric Williams
Keyword(s):  
Villous Adenoma ◽  
High Grade Dysplasia ◽  
Adenocarcinoma In Situ ◽  
High Grade

scholarly journals Metachronous neoplasms in patients with laterally spreading tumours during surveillance

2020 ◽  
pp. 205064062096531
Author(s):  
Roel MM Bogie ◽  
Bjorn Winkens ◽  
Sean JJ Retra ◽  
Chantal MC le Clercq ◽  
Mariëlle W Bouwens ◽  
...  
Keyword(s):  
Colorectal Neoplasms ◽  
Colorectal Neoplasm ◽  
Submucosal Invasion ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Age And Gender ◽  
Metachronous Neoplasms ◽  
Metachronous Colorectal Cancer ◽  
And Gender

Background Laterally spreading tumours represent a major challenge for endoscopic detection and resection. Objective To examine synchronous and metachronous neoplasms in patients with laterally spreading tumours. Methods We prospectively collected colonoscopy and histopathology data from patients who underwent colonoscopy in our centre at up to 6 years’ follow-up. Post-resection surveillance outcomes between laterally spreading tumours, flat colorectal neoplasms 10 mm or greater, and large polypoid colorectal neoplasms, polypoid colorectal neoplasms 10 mm or greater, were compared. Results Between 2008 and 2012, 8120 patients underwent colonoscopy for symptoms (84.6%), screening (6.7%) or surveillance (8.7%). At baseline, 151 patients had adenomatous laterally spreading tumours and 566 patients had adenomatous large polypoid colorectal neoplasms. Laterally spreading tumour patients had more synchronous colorectal neoplasms than large polypoid colorectal neoplasm patients (mean 3.34 vs. 2.34, P < 0.001). Laterally spreading tumour patients significantly more often developed metachronous colorectal neoplasms (71.6% vs. 54.2%, P = 0.0498) and colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients (36.4% vs. 15.8%, P < 0.001). After correction for age and gender, laterally spreading tumour patients were more likely than large polypoid colorectal neoplasm patients to develop a colorectal neoplasm with high grade dysplasia or submucosal invasion (hazard ratio 2.9, 95% confidence interval 1.8–4.6). The risk of metachronous colorectal cancer was not significantly different in laterally spreading tumours compared to large polypoid colorectal neoplasm patients. Conclusion Patients with laterally spreading tumours developed more metachronous colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients. Based on these findings endoscopic treatment and surveillance recommendations for patients with laterally spreading tumours should be optimised.

406 REVIEWING THE DYSPLASIA DURING LONG FU OF BARRETT’S ESOPHAGUS. SHOULD WE RELY ON THE DIAGNOSIS OF DYSPLASIA?

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Szachnowicz ◽  
A Duarte ◽  
B Mattos ◽  
K Iriya ◽  
E Bianchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Great Difficulty ◽  
Endoscopic Examination ◽  
High Grade ◽  
Multiple Biopsies ◽  
Pathological Review

Abstract   Barrett’ s esophagus (BE) is a complication of severe gastroesophageal reflux disease (GERD). The major concern aspect is its association to dysplasia and esophageal adenocarcinoma. The endoscopic treatment of the epithelium, as well as the follow-up (FU) period, should be guided according to the diagnosis and the worst degree of dysplasia found in the last endoscopies. However, we are aware of the great difficulty and variation among pathologists in diagnosing and grading dysplasia in BE. Methods Aim: Review new diagnoses of low- and high-grade dysplasia (LGD and HGD) in BE with specialized pathologists during long-term FU in clinical or surgical treatment for GERD From January 1980 to July 2019, 738 patients with BE were FU (average of 98 months), with routine endoscopic examination each 2 years with multiple biopsies, in patients with BE without dysplasia. 48 patients were diagnosed with any grade of dysplasia on FU endoscopic biopsies. The biopsies were reviewed by specialized pathologists and evaluated epidemiologic data, clinical or surgical treatment for the GERD and about the confirmation, downgrade or upgrade of dysplasia degree. Results 48 patients were reviewed, 32 males. The medium age was 61,9 YO (29 -93). Only 18 patients were in follow-up after surgical treatment for GERD. 9 patients had first diagnosis of in situ Adenocarcinoma, after review 8 were confirmed and treated and 1 were downgrade to HGD. 8 patients had first HGD and after review, 2 were upgrade to Adenocarcinoma, 4 were confirmed as HGD (endoscopic treatment) and 2 downgraded to no dysplasia BE. 31 patients had first LGD. 2 had upgrade to HGD/Adeno, 8 are in FU annually and 21 were downgrade to non dysplastic BE. Conclusion The diagnosis of dysplasia in BE remains a challenge. 23 of 48 (47%) of our patients once marked with any grade of dysplasia, were downgrade after pathological review and FU to non dysplasic BE. These difficulty of appropriate dysplasia degree diagnosis could make some mistakes in BE treatment and surveilance.

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