Original ResearchClinical—Alimentary TractRisk Factors for Progression of Low-Grade Dysplasia in Patients With Barrett's Esophagus
Section snippets
Patients
The Barrett's Esophagus Study (BEST) is a multicenter outcomes project that includes 5 tertiary care referral centers with an interest in BE. These include the Veterans Affairs Medical Center, Kansas City, Missouri; Southern Arizona Veterans Affairs Health Care System, Tucson, Arizona; Cleveland Clinic, Cleveland, Ohio; Veterans Affairs Medical Center, Portland, Oregon; and Bethesda Naval Medical Center, Bethesda, Maryland. The study was approved by the institutional review board at each
Results
Of the 2264 patients with BE, 210 patients met the inclusion criteria for this analysis. The mean age of this cohort was 60.6 years (SD, 12.06), and the vast majority was white (97.9%). This cohort included 85% men and 15% women with a mean follow-up of 6.22 years (SD, 4.35) for a total of 959.6 patient-years. The mean BE length was 4.39 cm (SD, 3.7). Hiatal hernia was present in 71% of the patients with a mean hiatal hernia length of 3.74 cm (SD, 2). The flow of patients in this study and
Discussion
The results of this large multicenter cohort of patients with BE that included 210 patients with LGD with a mean follow-up of 6.22 years (959.6 patient-years) show that the incidence of EAC was 0.44%/year (95% CI, 0.2–0.98) with a mean time of progression of 4.41 years. The rate of progression to HGD was 1.6%/year (95% CI, 1.05–2.46) and 1.83%/year (95% CI, 1.23–2.74) using an end point of HGD/EAC with a mean time of progression of 2.86 years and 3.08 years, respectively. Survival analysis
Acknowledgments
Results of this study were presented in part at Digestive Diseases Week 2009 in Chicago, Illinois.
References (31)
- et al.
How to manage a Barrett's esophagus patient with low-grade dysplasia
Clin Gastroenterol Hepatol
(2009) - et al.
Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis
Gastrointest Endosc
(2008) - et al.
The incidence of adenocarcinoma and dysplasia in Barrett's esophagus: report on the Cleveland Clinic Barrett's Esophagus Registry
Am J Gastroenterol
(1999) - et al.
The diagnosis of low-grade dysplasia in Barrett's esophagus and its implications for disease progression
Am J Gastroenterol
(2000) - et al.
Predictors of progression to cancer in Barrett's esophagus: baseline histology and flow cytometry identify low- and high-risk patient subsets
Am J Gastroenterol
(2000) - et al.
Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: a follow-up study based on 138 cases from a diagnostic variability study
Hum Pathol
(2001) - et al.
Long-term nonsurgical management of Barrett's esophagus with high-grade dysplasia
Gastroenterology
(2001) - et al.
p53 protein overexpression in low grade dysplasia (LGD) in Barrett's esophagus: immunohistochemical marker predictive of progression
Am J Gastroenterol
(2001) - et al.
Long-term endoscopic surveillance of patients with Barrett's esophagusIncidence of dysplasia and adenocarcinoma: a prospective study
Am J Gastroenterol
(2003) - et al.
Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus
Clin Gastroenterol Hepatol
(2006)
Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett's esophagus: international, partially blinded, randomized phase III trial
Gastrointest Endosc
Endoscopic eradication of Barrett's esophagus
Gastrointest Endosc
Extent of high-grade dysplasia in Barrett's esophagus correlates with risk of adenocarcinoma
Gastroenterology
Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation
Hum Pathol
A critical review of the diagnosis and management of Barrett's esophagus: the AGA Chicago Workshop
Gastroenterology
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Conflicts of interest The authors disclose no conflicts.