دورية أكاديمية
Analysis of metastases rates during follow-up after endoscopic resection of early “high-risk” esophageal adenocarcinoma
| العنوان: | Analysis of metastases rates during follow-up after endoscopic resection of early “high-risk” esophageal adenocarcinoma |
|---|---|
| المؤلفون: | Nieuwenhuis, Esther A., van Munster, Sanne N., Meijer, Sybren L., Brosens, Lodewijk A. A., Jansen, Marnix, Weusten, Bas L. A. M., Alvarez Herrero, Lorenza, Alkhalaf, Alaa, Schenk, Ed, Schoon, Erik J., Curvers, Wouter L., Koch, Arjun D., van de Ven, Steffi E. M., Verheij, Eva P. D., Nagengast, Wouter B., Westerhof, Jessie, Houben, Martin H. M. G., Tang, Thjon, Bergman, Jacques J. G. H. M., Pouw, Roos E., Karrenbeld, A., Ooms, A., Huysentruyt, C., ten Kate, F., Moll, F., Kats-Ugurlu, G., van Lijnschoten, I., van de Laan, J., Offerhaus, J., Biermann, K., Seldenrijk, K., Brosens, L., Meijer, S., Doukas, M. |
| المصدر: | Nieuwenhuis , E A , van Munster , S N , Meijer , S L , Brosens , L A A , Jansen , M , Weusten , B L A M , Alvarez Herrero , L , Alkhalaf , A , Schenk , E , Schoon , E J , Curvers , W L , Koch , A D , van de Ven , S E M , Verheij , E P D , Nagengast , W B , Westerhof , J , Houben , M H M G , Tang , T , Bergman , J J .... |
| سنة النشر: | 2022 |
| الوصف: | Background and Aims: After endoscopic resection (ER) of early esophageal adenocarcinoma (EAC), the optimal management of patients with high-risk histologic features for lymph node metastases (ie, submucosal invasion, poor differentiation grade, or lymphovascular invasion) remains unclear. We aimed to evaluate outcomes of endoscopic follow-up after ER for high-risk EAC. Methods: For this retrospective cohort study, data were collected from all Dutch patients managed with endoscopic follow-up (endoscopy, EUS) after ER for high-risk EAC between 2008 and 2019. We distinguished 3 groups: intramucosal cancers with high-risk features, submucosal cancers with low-risk features, and submucosal cancers with high-risk features. The primary outcome was the annual risk for metastases during follow-up, stratified for baseline histology. Results: One hundred twenty patients met the selection criteria. Median follow-up was 29 months (interquartile range, 15-48). Metastases were observed in 5 of 25 (annual risk, 6.9%; 95% confidence interval [CI], 3.0-15) high-risk intramucosal cancers, 1 of 55 (annual risk, .7%; 95% CI, 0-4.0) low-risk submucosal cancers, and 3 of 40 (annual risk, 3.0%; 95% CI, 0-7.0) high-risk submucosal cancers. Conclusions: Whereas the annual metastasis rate for high-risk submucosal EAC (3.0%) was somewhat lower than expected in comparison with previous reported percentages, the annual metastasis rate of 6.9% for high-risk intramucosal EAC is new and worrisome. This calls for further prospective studies and suggests that strict follow-up of this small subgroup is warranted until prospective data are available. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://research.vumc.nl/en/publications/4ec5822f-10e1-441c-835d-575043cbf08bTest |
| DOI: | 10.1016/j.gie.2022.03.005 |
| الإتاحة: | https://doi.org/10.1016/j.gie.2022.03.005Test https://research.vumc.nl/en/publications/4ec5822f-10e1-441c-835d-575043cbf08bTest http://www.scopus.com/inward/record.url?scp=85132381792&partnerID=8YFLogxKTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.4EB6EE4B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.gie.2022.03.005 |
|---|