Retrospective Cohort Study: Barrett's esophagus with high grade dysplasia is associated with non-esophageal cancer

מאת: Bar N., Schwartz N., Nissim M., Fliss-Isacov N., Zelber-Sagi S., Kariv R.
פורסם ב: World Journal of Gastroenterology
תיאור: Aim: To study factors associated with esophageal and nonesophageal cancer morbidity among Barrett's esophagus (BE) patients. Methods: A cohort study within a single tertiary center included 386 consecutive patients with biopsy proven BE, who were recruited between 2004-2014. Endoscopic and histologic data were prospectively recorded. Cancer morbidity was obtained from the national cancer registry. Main outcomes were BE related (defined as esophagus and cardia) and non-BE related cancers (all other cancers). Cancer incidence and all-cause mortality were compared between patients with highgrade dysplasia (HGD) and with low-grade or no dysplasia (non-HGD) using Kaplan-Meier curves and cox regression models. Results: Of the 386 patients, 12 had HGD, 7 had a BE related cancer. There were 75 (19.4%) patients with 86 cases of lifetime cancers, 76 of these cases were non-BE cancers. Seven (1.8%) and 18 (4.7%) patients had BE and non-BE incident cancers, respectively. Twelve (3.1%) patients had HGD as worst histologic result. Two (16.7%) and 16 (4.4%) incident non-BE cancers occurred in the HGD and non-HGD group, respectively. Ten-year any cancer and non-BE cancer free survival was 63% and 82% in the HGD group compared to 93% and 95% at the non-HGD group, respectively. Log-rank test for patients with more than one endoscopy, assuring longer follow up, showed a significant difference (P < 0.001 and P = 0.017 respectively). All-cause mortality was not significantly associated with BE HGD. Conclusion: Patients with BE and HGD, may have a higher risk for all-cause cancer morbidity. The implications on cancer prevention recommendations should be further studied. © 2018 The Author(s). Published by Baishideng Publishing Group Inc. All rights reserved. SDGs : SDG 03  |  יחידות: מדעי הרווחה והבריאות  | מועד: 2018 |  קישור