Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection

Bashar J. Qumseya, Abraham M. Panossian, Cynthia Rizk, David J. Cangemi, Christianne Wolfsen, Massimo Raimondo, Timothy A. Woodward, Michael B. Wallace, Herbert C. Wolfsen

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: Endoscopic resection followed by ablative therapy is frequently used to treat esophageal high-grade dysplasia or early esophageal adenocarcinoma. Aims: To study outcomes in patients with high-grade dysplasia compared to those with esophageal adenocarcinoma after endoscopic resection. Methods: Retrospective, observational, descriptive, single-centre study from a prospective database. We extracted data from 116 endoscopic resections. Survival was plotted using Kaplan-Meier curves multivariable Cox-proportional hazard assess for possible predictors of survival post-endoscopic resection was performed. Results: 116 patients (64 esophageal adenocarcinoma, 52 high-grade dysplasia) underwent endoscopic resection from May 2003 to June 2010. Mean age was 71 ± 11 years for high-grade dysplasia and 72 ± 10 years for esophageal adenocarcinoma. Median follow-up was 17 months. Eighty-five patients had negative margins on endoscopic resection. Five-year survivals for high-grade dysplasia and esophageal adenocarcinoma were 86% (range 68-100%) and 78% (59-96%), respectively. Survival was not significantly different between groups (p = 0.20). Overall mortality rate was 10.6% (9/85). At multivariable Cox regression increased Barrett's oesophagus length was associated with worse survival (HR 1.18 [1.06-1.33], p= 0.0039). Survival was not affected by the pathology before resection: HR 2.4 [95%CI, 0.70-8.4], p= 0.16. Conclusions: Survival in patients with high-grade dysplasia of the oesophagus is similar to those with esophageal adenocarcinoma. Longer Barrett's oesophagus segments are associated with decreased survival.

Original languageEnglish (US)
Pages (from-to)1028-1033
Number of pages6
JournalDigestive and Liver Disease
Volume45
Issue number12
DOIs
StatePublished - Dec 1 2013

Keywords

  • Barrett oesophagus
  • Endoscopic resection
  • Esophageal adenocarcinoma
  • Longterm survival

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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  • Cite this

    Qumseya, B. J., Panossian, A. M., Rizk, C., Cangemi, D. J., Wolfsen, C., Raimondo, M., Woodward, T. A., Wallace, M. B., & Wolfsen, H. C. (2013). Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection. Digestive and Liver Disease, 45(12), 1028-1033. https://doi.org/10.1016/j.dld.2013.06.009