Mo1110 Efficacy of Multimodality Endoscopic Eradication Therapy in the Treatment of Barrett's Esophagus (BE): A Systematic Review and Meta-Analysis

Background and aims: A high rate of neoplasia (high grade dysplasia; HGD and esophageal adenocarcinoma; EAC) has been reported in Barrett’s Esophagus at index endoscopy but precise rates of post endoscopy Barrett’s neoplasia (PEBN) are unknown. Methods: Systematic review and meta-analysis was performed examining electronic databases (inception to October 2021) for studies reporting PEBN. Consistent with definitions of Post Colonoscopy Colorectal Cancer as proposed by the World Endoscopy Organization, we defined neoplasia(HGD/EAC) detected at index endoscopy and/or within 6 months of a negative index endoscopy as “prevalent” neoplasia; those detected after 6 months of a negative index endoscopy and prior to next surveillance interval(i.e. 3 years) as PEBN or “interval” neoplasia, and those detected after 36 months of a negative index endoscopy as “incident” neoplasia. Pooled incidence rates and proportion relative to total neoplasia were analyzed. Results: 11 studies (n=59,795, age:62.3±3.3 years, 61%males) met inclusion criteria. The pooled incidence rates were: prevalent neoplasia 4.5% (95%confidence interval: 2.2-8.9) at baseline and additional 0.3%(0.1-0.7) within first 6 months, PEBN 0.52%(0.48-0.58) and incident neoplasia: 1.41%(0.93-2.14). At 3 years from index endoscopy, PEBN accounted for 3% while prevalent neoplasia accounted for 97% of total Barrett’s neoplasia. Conclusion: Neoplasia detected at or within 6 months of index endoscopy account for most of the Barrett’s neoplasia(>90%). Post-Endoscopy Barrett’s Neoplasia account for ~3% of cases and can be used for validation in future. This highlights the importance of a high-quality index endoscopy in Barrett’s Esophagus and the need to establish quality benchmarks to measure endoscopists’ performance.

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Correction: Prevalence of Barrett’s esophagus in obese patients undergoing pre-bariatric surgery evaluation: a systematic review and meta-analysis

Endoscopy ◽

10.1055/a-1174-3656 ◽

2020 ◽

Vol 52 (07) ◽

pp. C8-C8

Author(s):

Bashar Qumseya ◽

Sherif Gendy ◽

Alexander Wallace ◽

Dennis Yang ◽

Davis Estores ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Meta Analysis ◽

Obese Patients

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Liquid Nitrogen Spray Cryotherapy in Treatment of Barrett's Esophagus, where do we stand? A Systematic Review and Meta-Analysis

Diseases of the Esophagus ◽

10.1093/dote/doy130 ◽

2019 ◽

Vol 32 (6) ◽

Cited By ~ 3

Author(s):

B P Mohan ◽

R Krishnamoorthi ◽

S Ponnada ◽

M Shakhatreh ◽

M Jayaraj ◽

...

Keyword(s):

Systematic Review ◽

Barrett’S Esophagus ◽

Liquid Nitrogen ◽

Barrett's Esophagus ◽

Meta Analysis

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Significantly lower annual rates of neoplastic progression in short- compared to long-segment non-dysplastic Barrett’s esophagus: a systematic review and meta-analysis

Endoscopy ◽

10.1055/a-0869-7960 ◽

2019 ◽

Vol 51 (07) ◽

pp. 665-672 ◽

Cited By ~ 8

Author(s):

Viveksandeep Thoguluva Chandrasekar ◽

Nour Hamade ◽

Madhav Desai ◽

Tarun Rai ◽

Venkata Subhash Gorrepati ◽

...

Keyword(s):

Systematic Review ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Neoplastic Progression ◽

Number Of Patients ◽

The Mean ◽

Surveillance Endoscopy

Abstract Background Although shorter lengths of Barrett’s esophagus (BE) have been associated with a lower risk of neoplastic progression, precise estimates have varied, especially for non-dysplastic BE (NDBE) only. Therefore, current US guidelines do not provide specific recommendations on surveillance intervals based on BE length. We performed a systematic review and meta-analysis of the published literature to examine neoplastic progression rates of NDBE based on BE length. Methods PubMed, Cochrane, Google Scholar, and Embase were comprehensively searched. Studies reporting progression rates in patients with NDBE and > 1 year of follow-up were included. The number of patients progressing to esophageal adenocarcinoma (EAC) and high grade dysplasia (HGD)/EAC in individual studies and the mean follow-up were recorded to derive person-years of follow-up. Pooled rates of progression to EAC and HGD/EAC based on BE length (< 3 cm vs. ≥ 3 cm) were calculated. Results Of the 486 initial studies identified, 10 met the inclusion/exclusion criteria. These included a total of 4097 NDBE patients; 1979 with short-segment BE (SSBE; 10 773 person-years of follow-up) and 2118 with long-segment BE (LSBE; 12 868 person-years). The annual rates of progression to EAC were significantly lower for SSBE compared with LSBE: 0.06 % (95 % confidence interval 0.01 % – 0.10 %) vs. 0.31 % (0.21 % – 0.40 %), respectively; odds ratio (OR) 0.25 (0.11 – 0.56); P < 0.001, as were the rates for the combined endpoint (HGD/EAC): 0.24 % (0.09 % – 0.32 %) vs. 0.76 % (0.43 % – 0.89 %), respectively; OR 0.35 (0.21 – 0.58); P < 0.001. There was no significant heterogeneity among studies. Conclusion The results demonstrate significantly lower rates of neoplastic progression in NDBE patients with SSBE compared with LSBE. BE length can easily be used for risk stratification purposes for NDBE patients undergoing surveillance endoscopy and consideration should be given to tailoring surveillance intervals based on BE length in future US guidelines.

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