Details

Autor(en) / Beteiligte

• 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.

Titel

Analysis of metastases rates during follow-up after endoscopic resection of early “high-risk” esophageal adenocarcinoma

Ist Teil von

• Gastrointestinal endoscopy, 2022-08, Vol.96 (2), p.237-247.e3

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• 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. 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. 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. 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.