How is early Barrett's cancer currently diagnosed and treated in Western Europe? Results of a survey at 52 university hospitals in eight Western European countries.
Z Gastroenterol
; 50(7): 670-6, 2012 Jul.
Article
en En
| MEDLINE
| ID: mdl-22760678
ABSTRACT
BACKGROUND AND STUDY AIMS:
Endoscopic treatment is increasingly being accepted for early Barrett's cancer (EBC), as it is associated with few complications, excellent long-term results, and almost no mortality. This study investigated current standards and treatment strategies for EBC in eight countries in Western Europe.METHODS:
A standardized questionnaire with questions on the endoscopic diagnosis, staging, and treatment of EBC was developed and sent to 107 university gastroenterology departments. The data were analyzed anonymously.RESULTS:
The response rate was 49 % (52/107). For work-up of early Barrett's neoplasia, 67 % of hospitals use high-resolution endoscopes, with routine four-quadrant and targeted biopsies of visible lesions in 94 % of the cases. Narrow-band imaging and chromoendoscopy are used in 67 % of the cases, and other advanced imaging and staining techniques in 65 %. Before treatment, 63 % of the respondents recommended conventional endosonography, 6 % miniprobe endosonography, and 19 % both. Endoscopic resection is carried out at 98 % of the hospitals. Argon plasma coagulation is used for ablation in 52 % of the cases and radiofrequency ablation in 27 %. An 80-year-old patient with localized mucosal EBC would be treated endoscopically in all of the hospitals. Endoscopic therapy was recommended for 50-year-old patients with mucosal EBC by 87 % of the hospitals; esophageal resection was recommended for multifocal EBC by 15 % in 80-year-old patients, by 63 % in 50-year-old patients and by 44 % in patients with incipient submucosal infiltration.CONCLUSIONS:
About two-thirds of the university hospitals use high-resolution endoscopy and advanced imaging. Endoscopic therapy is the accepted standard for treating localized mucosal Barrett's cancer in Western Europe; esophageal resection is recommended by the majority (63 %) for a young patient with multifocal EBC.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Esófago de Barrett
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Pautas de la Práctica en Medicina
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Neoplasias Esofágicas
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Endoscopía Gastrointestinal
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Hospitales Universitarios
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Guideline
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
País como asunto:
Europa
Idioma:
En
Año:
2012
Tipo del documento:
Article