Threshold evaluation for optimal number of endoscopic treatment sessions to achieve complete eradication of Barrett's metaplasia.
Endoscopy
; 54(10): 927-933, 2022 10.
Article
em En
| MEDLINE
| ID: mdl-35135015
ABSTRACT
BACKGROUND:
Endoscopic eradication therapy (EET) is the standard of care for Barrett's esophagus (BE)-associated neoplasia. Previous data suggest the mean number of EET sessions required to achieve complete eradication of intestinal metaplasia (CE-IM) is 3.âThis study aimed to define the threshold of EET sessions required to achieve CE-IM.METHODS:
The TREAT-BE Consortium is a multicenter outcomes cohort including prospectively enrolled patients with BE undergoing EET. All patients achieving CE-IM were included. Demographic, endoscopic, and histologic data were recorded at treatment onset along with treatment details and surveillance data. Kaplan-Meier analysis was performed to define a threshold of EET sessions, with 95â%CI, required to achieve CE-IM. A secondary analysis examined predictors of incomplete response to EET using multiple logistic regression and recurrence rates.RESULTS:
623 patients (mean age 65.2 [SD 11.6], 79.6â% male, 86.5â% Caucasian) achieved CE-IM in a mean of 2.9 (SD 1.7) EET sessions (median 2) and a median total observation period of 2.7 years (interquartile range 1.4-5.0). After three sessions, 73â% of patients achieved CE-IM (95â%CI 70â%-77â%). Age (odds ratio [OR] 1.25, 95â%CI 1.05-1.50) and length of BE (OR 1.24, 95â%CI 1.17-1.31) were significant predictors of incomplete response.CONCLUSION:
The current study found that a threshold of three EET sessions would achieve CE-IM in the majority of patients. Alternative therapies and further diagnostic testing should be considered for patients who do not have significant response to EET after three sessions.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
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Neoplasias Esofágicas
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Ablação por Cateter
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Ressecção Endoscópica de Mucosa
Tipo de estudo:
Clinical_trials
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Prognostic_studies
Limite:
Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article