A survey of expert follow-up practices after successful endoscopic eradication therapy for Barrett's esophagus with high-grade dysplasia and intramucosal adenocarcinoma.
Gastrointest Endosc
; 78(5): 696-701, 2013 Nov.
Article
en En
| MEDLINE
| ID: mdl-23711553
ABSTRACT
BACKGROUND:
Despite the increasing number of patients undergoing endoscopic therapy for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC), there are few data to guide clinical decision making and research initiatives in the area of posttreatment follow-up.OBJECTIVES:
We aimed to define expert practice patterns regarding follow-up after endoscopic treatment of BE with HGD and IMC.DESIGN:
Electronic survey.SUBJECTS:
Forty-eight endoscopists in the United States with expertise in BE endotherapy based on high-impact publications and national reputation. INTERVENTION A 21-item Web-based survey inquiring about post-BE endotherapy follow-up practices.RESULTS:
Of 48 expert endoscopists, 42 completed the survey. After successful treatment of BE with HGD or IMC, all experts perform surveillance upper endoscopy, most commonly at 3-month intervals in the first posttreatment year, every 6 months during the second year, and annually thereafter. None of the experts perform surveillance EUS after treatment of HGD, and only 19% perform EUS after treatment of IMC. After cancer eradication, only 36% of experts refer patients for CT, and 24% refer patients for positron emission tomography. Thirty-eight percent of experts refer patients for a surgical opinion when IMC extends into the muscularis mucosa; 100% refer when IMC extends into submucosa.LIMITATIONS:
Not a consensus document; only U.S. experts included.CONCLUSIONS:
This study reports the follow-up practices of expert endoscopists after successful endotherapy for BE with HGD and IMC. Additional research is necessary to establish optimal surveillance intervals, the role of follow-up EUS, CT, and positron emission tomography, as well as the surgical implications of low-risk IMC extending into the muscularis mucosa.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
Problema de salud:
11_delivery_arrangements
Asunto principal:
Esófago de Barrett
/
Neoplasias Esofágicas
/
Adenocarcinoma
/
Cuidados Posteriores
/
Gastroenterología
/
Recurrencia Local de Neoplasia
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Gastrointest Endosc
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos