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

10 Citations (Scopus)

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 2013

Fingerprint

Adenocarcinoma
Survival
Barrett Esophagus
Esophagus
Outcome Assessment (Health Care)
Databases
Prospective Studies
Pathology
Mortality

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Qumseya, B. J., Panossian, A. M., Rizk, C., Cangemi, D. J., Wolfsen, C., Raimondo, M., ... 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

Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection. / Qumseya, Bashar J.; Panossian, Abraham M.; Rizk, Cynthia; Cangemi, David J.; Wolfsen, Christianne; Raimondo, Massimo; Woodward, Timothy A.; Wallace, Michael B.; Wolfsen, Herbert C.

In: Digestive and Liver Disease, Vol. 45, No. 12, 12.2013, p. 1028-1033.

Research output: Contribution to journalArticle

Qumseya, BJ, Panossian, AM, Rizk, C, Cangemi, DJ, Wolfsen, C, Raimondo, M, Woodward, TA, Wallace, MB & Wolfsen, HC 2013, 'Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection', Digestive and Liver Disease, vol. 45, no. 12, pp. 1028-1033. https://doi.org/10.1016/j.dld.2013.06.009
Qumseya, Bashar J. ; Panossian, Abraham M. ; Rizk, Cynthia ; Cangemi, David J. ; Wolfsen, Christianne ; Raimondo, Massimo ; Woodward, Timothy A. ; Wallace, Michael B. ; Wolfsen, Herbert C. / Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection. In: Digestive and Liver Disease. 2013 ; Vol. 45, No. 12. pp. 1028-1033.
@article{6b6fcfefc4444e91986b99369b361b0f,
title = "Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection",
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.",
keywords = "Barrett oesophagus, Endoscopic resection, Esophageal adenocarcinoma, Longterm survival",
author = "Qumseya, {Bashar J.} and Panossian, {Abraham M.} and Cynthia Rizk and Cangemi, {David J.} and Christianne Wolfsen and Massimo Raimondo and Woodward, {Timothy A.} and Wallace, {Michael B.} and Wolfsen, {Herbert C.}",
year = "2013",
month = "12",
doi = "10.1016/j.dld.2013.06.009",
language = "English (US)",
volume = "45",
pages = "1028--1033",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "12",

}

TY - JOUR

T1 - Survival in esophageal high-grade dysplasia/adenocarcinoma post endoscopic resection

AU - Qumseya, Bashar J.

AU - Panossian, Abraham M.

AU - Rizk, Cynthia

AU - Cangemi, David J.

AU - Wolfsen, Christianne

AU - Raimondo, Massimo

AU - Woodward, Timothy A.

AU - Wallace, Michael B.

AU - Wolfsen, Herbert C.

PY - 2013/12

Y1 - 2013/12

N2 - 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.

AB - 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.

KW - Barrett oesophagus

KW - Endoscopic resection

KW - Esophageal adenocarcinoma

KW - Longterm survival

UR - http://www.scopus.com/inward/record.url?scp=84887182711&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887182711&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2013.06.009

DO - 10.1016/j.dld.2013.06.009

M3 - Article

C2 - 23938135

AN - SCOPUS:84887182711

VL - 45

SP - 1028

EP - 1033

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 12

ER -