scholarly journals A Barrett's esophagus registry of over 1000 patients from a specialist center highlights greater risk of progression than population-based registries and high risk of low grade dysplasia

2014 ◽  
Vol 28 (2) ◽  
pp. 121-126 ◽  
Author(s):  
S. L. Picardo ◽  
M. P. O'Brien ◽  
R. Feighery ◽  
D. O'Toole ◽  
N. Ravi ◽  
...  
Keyword(s):  
High Risk ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Population Based ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia ◽  
Specialist Center

Low-grade dysplasia in Barrett's esophagus has a high risk of progression

Endoscopy ◽  
2007 ◽  
Vol 39 (07) ◽  
pp. 581-587 ◽  
Author(s):  
C. Lim ◽  
D. Treanor ◽  
M. Dixon ◽  
A. Axon
Keyword(s):  
High Risk ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia

384 Low-Grade Dysplasia in Barrett's Esophagus Has a High Risk of Progression When Confirmed by a Panel of Expert Pathologists

2013 ◽  
Vol 144 (5) ◽  
pp. S-73-S-74 ◽  
Author(s):  
Lucas C. Duits ◽  
Kai Yi N. Phoa ◽  
Wouter L. Curvers ◽  
Fiebo J. ten Kate ◽  
Gerrit A. Meijer ◽  
...  
Keyword(s):  
High Risk ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia

scholarly journals Yield of Repeat Endoscopy in Barrett’s Esophagus with No Dysplasia and Low-Grade Dysplasia: A Population-Based Study

2015 ◽  
Vol 61 (1) ◽  
pp. 158-167 ◽  
Author(s):  
Kavel Visrodia ◽  
Prasad G. Iyer ◽  
Cathy D. Schleck ◽  
Alan R. Zinsmeister ◽  
David A. Katzka
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Population Based ◽  
Low Grade ◽  
Population Based Study ◽  
Repeat Endoscopy ◽  
Low Grade Dysplasia

Barrett’s Registry Collaboration of academic centers in Ireland reveals high progression rate of low-grade dysplasia and low risk from nondysplastic Barrett’s esophagus: report of the RIBBON network

2020 ◽  
Vol 33 (10) ◽  
Author(s):  
Lisa M O’Byrne ◽  
Jolene Witherspoon ◽  
Roy J J Verhage ◽  
Marie O’Brien ◽  
Cian Muldoon ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Population Based ◽  
First Year ◽  
Progression Rate ◽  
Low Grade ◽  
Female Ratio ◽  
Ablative Therapies ◽  
Low Grade Dysplasia

Summary Barrett’s esophagus (BE) is the main pathological precursor of esophageal adenocarcinoma (EAC). Progression to high-grade dysplasia (HGD) or EAC from nondysplastic BE (NDBE), low-grade dysplasia (LGD) and indefinite for dysplasia (IND) varies widely between population-based studies and specialized centers for many reasons, principally the rigor of the biopsy protocol and the accuracy of pathologic definition. In the Republic of Ireland, a multicenter prospective registry and bioresource (RIBBON) was established in 2011 involving six academic medical centers, and this paper represents the first report from this network. A detailed clinical, endoscopic and pathologic database registered 3,557 patients. BE was defined strictly by both endoscopic evidence of Barrett’s epithelium and the presence of specialized intestinal metaplasia (SIM). A prospective web-based database was used to gather information with initial and follow-up data abstracted by a data manager at each site. A total of 2,244 patients, 1,925 with no dysplasia, were included with complete follow-up. The median age at diagnosis was 60.5 with a 2.1:1 male to female ratio and a median follow-up time of 2.7 years (IQR 1.19–4.04), and 6609.25 person years. In this time period, 125 (5.57%) progressed to HGD/EAC, with 74 (3.3%) after 1 year of follow-up and 38 (1.69%) developed EAC, with 20 (0.89%) beyond 1 year. The overall incidence of HGD/EAC was 1.89% per year; 1.16% if the first year is excluded. The risk of progression to EAC alone overall was 0.57% per year, 0.31% excluding the first year, and 0.21% in the 1,925 patients who had SIM alone at diagnosis. Low-grade dysplasia (LGD) progressed to HGD/EAC in 31% of patients, a progression rate of 12.96% per year, 6.71% with the first year excluded. In a national collaboration of academic centers in Ireland, the progression rate for NDBE was similar to recent population studies. Almost one in two who progressed was evident within 1 year. Crucially, LGD diagnosed and confirmed by specialist gastrointestinal pathologists represents truly high-risk disease, highlighting the importance of expertise in diagnosis and management, and providing indirect support for ablative therapies in this context.

FA02.05: PROGRESSION RATE OF BARRETT’S ESOPHAGUS FROM NATIONAL REGISTRY OF EXPERT CENTERS IS MUCH GREATER THAN ANTICIPATED FROM POPULATION STUDIES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 4-4
Author(s):  
Lisa O'Byrne ◽  
Roy Verhage ◽  
Marie O'Brien ◽  
Dermot O'Toole ◽  
Cian Muldoon ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Population Studies ◽  
First Year ◽  
Progression Rate ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia ◽  
One Year

Abstract Background Barrett's Esophagus (BE) is well established as the main pathological precursor for esophageal adenocarcinoma (EAC). Progression to high grade dysplasia (HGD) or EAC varies widely between population based studies and specialized BE registries from high volume centers. No such data existed from the Republic of Ireland until 2011 when a multicenter registry was established involving three centers to more accurately determine the risk of progression to EAC in the Irish population. Methods A detailed clinical, endoscopic and pathological database includes 3397 patients from January 2008 to July 2017, with BE defined by the presence of specialized intestinal metaplasia (SIM). A prospective web based database was used to gather information from three designated esophageal centers with initial and follow up data abstracted by a data manager and overseen by a project manager. Results 325 were excluded following a diagnosis of HGD or EAC at index biopsy, or being a tertiary referral, leaving 3072 with a median age of 61 and a 2.1:1 male to female ratio and a median follow up of 3 years, and 5024 person years. 127 (4%) cases progressed to HGD/EAC, 65 after one year of follow up. 55 (2%) developed EAC were identified, 30 of those within one year. The overall incidence HGD/EAC was 2.53% per year, 1.3% if the first year is excluded. The risk of progression to EAC alone was 1.09% per year, 0.5% excluding the first year. Low grade dysplasia (LGD) on index biopsy was associated with a progression rate of 11.7% per year, 4.2% with the first year excluded. Conclusion With strict data entry and pathologic quality assurance, progression rates for non-dysplastic BE was several fold higher than population studies, highlighting caution in abstracting from population data. True LGD, as evidenced in a recent report by Kestens et al.1 represent high risk disease, with most of the risk evident within the first year. Reference: 1. Kestens C, Offerhaus G, van Baal J, Siersema PD. Patients wtih Barrett's esophagus and persistent low-grade dysplasia have an increased risk for high- grade dysplasia and cancer. Clin Gastroenterol Hepatol. 2016;14:956–962 Disclosure All authors have declared no conflicts of interest.

scholarly journals Outcomes of Radiofrequency ablation vs endoscopic surveillance for Barrett's esophagus with low-grade dysplasia: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Jagpal Singh Klair ◽  
Yousuf Zafar ◽  
Navroop Nagra ◽  
Arvind R. Murali ◽  
Mahendran Jayaraj ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiofrequency Ablation ◽  
Barrett’S Esophagus ◽  
Comparative Studies ◽  
Barrett's Esophagus ◽  
Meta Analysis ◽  
Endoscopic Surveillance ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia

BACKGROUND: Endoscopic therapy using radiofrequency ablation (RFA) is a recommended treatment for Barrett’s esophagus with high grade dysplasia (BE-HGD) without a visible lesion which is managed by resection. However, currently there is no consensus on the management of BE with low grade dysplasia (BE-LGD) – RFA vs endoscopic surveillance. Hence, we performed a systematic review and meta-analysis of these comparative studies to compare the risk of progression to HGD or esophageal adenocarcinoma (EAC) among patients with BE-LGD treated with RFA vs endoscopic surveillance. METHODS: The primary outcome was to compare the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA vs endoscopic surveillance. RESULTS: Four comparative studies reporting a total of 543 patients with BE-LGD were included in the meta-analysis (234 in RFA and 309 in endoscopic surveillance). The progression of BE-LGD to either HGD or EAC was significantly lower in patients treated with RFA compared to endoscopic surveillance (OR: 0.17, 95% CI: 0.04-0.65, p=0.01). The progression to HGD alone was significantly lower in patients treated with RFA vs endoscopic surveillance (OR: 0.23, 95% CI: 0.08-0.61, p=0.003). The progression to EAC alone was numerically lower in RFA compared to endoscopic surveillance without statistical significance (OR: 0.44, 95% CI: 0.17-1.16, p=0.09). Moderate heterogeneity was noted in the analysis. CONCLUSIONS: Based on our meta-analysis, there was a significant reduction in the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA compared with those undergoing endoscopic surveillance. Endoscopic eradication therapy with RFA should be the preferred management approach for BE-LGD

Risk of Progression after a Diagnosis of Low Grade Dysplasia Varies Between Hospitals for Patients Under Surveillance for Barrett's Esophagus

2017 ◽  
Vol 152 (5) ◽  
pp. S449
Author(s):  
Maulin Shah ◽  
Christopher Deitrick ◽  
Randall Brand ◽  
Jennifer S. Chennat ◽  
Kenneth Fasanella ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Low Grade ◽  
Risk Of Progression ◽  
Low Grade Dysplasia
Sign in / Sign up

Export Citation Format

Share Document