Adenocarcinoma of the Esophagus and Barrett's Esophagus: A Population-Based Study

Bytzer, Peter; Christensen, Peer Brehm; Damkier, Per; Vinding, Kirsten; Seersholm, Niels

doi:10.1111/j.1572-0241.1999.00776.x

Cited by 242 publications

(69 citation statements)

References 24 publications

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“…An answer to this intriguing finding remains unclear. We speculate that because patients with high BMI are diagnosed with GERD more often than those with low BMI, [19][20][21][22][23] patients with high BMI are more likely to undergo endoscopic surveillance and this could result in the diagnosis of early EC. Lagergren et al 11 reported an odds ratio of 7.7 for EAC among patients with GERD symptoms compared with individuals without GERD symptoms.…”

Section: Discussionmentioning

confidence: 99%

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Hayashi¹,

Correa²,

Hofstetter³

et al. 2010

Cancer

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BACKGROUND: High body mass index (BMI), a prevalent condition in the United States, is associated with esophageal adenocarcinoma (EAC). Its influence on a patient's outcome remains unclear. In the current study, the authors examined the impact of BMI on survival and complications in patients with esophageal cancer (EC) who underwent surgery as their primary therapy. METHODS: The authors retrospectively reviewed 301 consecutive EC patients who underwent surgery but received no adjunctive therapy. Patients were segregated into 2 subgroups based on their baseline BMI: normal/low (<25 kg/m 2 ) and high ( 25 kg/m 2 ). RESULTS: Seventy-six (25%) patients had a BMI <25 kg/m 2 and 225 (75%) patients had a BMI 25 kg/m 2 . In the high BMI group, there were more men (P < .001), fewer upper ECs (P ¼ .021), a lower baseline clinical stage (P ¼ .006), and frequent EAC (P < .001). Postoperative morbidity was similar in both groups, with the exception of gastrointestinal complications (P ¼ .016). The 5-year overall survival (OS) rates were 44% in the normal/low BMI group and 60% in the high BMI group (P ¼ .017). The 5-year disease-free survival (DFS) rates were 41% in the normal/low BMI group and 60% in the high BMI group (P ¼ .005). On multivariable analysis, age, weight loss, peripheral vascular disease (PVD), and both clinical and pathological stage of disease were found to be independent prognosticators for OS. Older age (hazard ratio [HR]

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Section: Discussionmentioning

confidence: 99%

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Hayashi¹,

Correa²,

Hofstetter³

et al. 2010

Cancer

View full text Add to dashboard Cite

show abstract

“…4 The incidence of these 2 types of cancers has progressively risen in the Western world. 2,[5][6][7][8] However, at the present time, it is impossible to predict which patients are at risk of neoplastic progression and all patients are advised to undergo a regular endoscopic followup. 9,10 BE patients have a 30 -125-fold increased risk of developing esophageal AC compared to the general population.…”

mentioning

confidence: 99%

Risk factors for Barrett's esophagus: A case‐control study

Conio¹,

Filiberti²,

Blanchi³

et al. 2001

Intl Journal of Cancer

139

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Barrett's esophagus (BE) is an acquired disorder due to chronic gastroesophageal reflux. Environmental factors seem to play an important role in the pathogenesis of BE, especially in Western society. A multicenter case-control study was carried out between February 1995 and April 1999 in 8 Italian Departments of Gastroenterology gathered in a study group (GOSPE), in order to analyze the influence of some individual characteristics and life-style habits on the occurrence of BE. Three groups of patients were studied: 149 patients with BE, 143 patients with esophagitis (E) and 308 hospital controls (C) with acute, non-neoplastic, non-gastroenterological conditions. The diagnosis of BE was based on endoscopy and histology. E was defined by the Savary classification (grade I-III). Data collection was performed by using a questionnaire that focused on smoking, coffee and alcohol consumption, medical history, drugs history, gastroesophageal reflux disease (GERD) symptoms (heartburn, regurgitation) and socio-economic status. Multivariate analysis showed that the frequency of weekly GERD symptoms was significantly associated with both BE and E (p<0.0001), such as the presence of hiatal hernia (p<0.001). Ulcer was significantly associated with BE (p‫.)100.0؍‬ Among patients with E, the risk was directly related to spirits consumption (p‫.)30.0؍‬ Patients with GERD symptoms that lasted more than 13 years were more likely to have BE than E (p‫.)10.0؍‬ In conclusion, results from our study point out that long-standing GERD symptoms, hiatal hernia and possibly alcohol consumption are risk factors in the development of the BE and E.

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“…In a population-based study reported by Bytzer et al (1999), more than 98% of esophageal adenocarcinoma was detected in patients with previously undiagnosed Barrett's esophagus. It has been postulated that intensive long-term treatment of GERD by anti-reflux therapies in patients with Barrett's esophagus may lower the incidence of esophageal adenocarcinoma (Hillman, 2004;Cooper, 2006;Nguyen et al, 2009).…”

Section: Barrett's Esophagus and β-Carotene Therapy: Symptomatic Imprmentioning

confidence: 96%

Barrett's Esophagus and β-carotene Therapy: Symptomatic Improvement in GERD and Enhanced HSP70 Expression in Esophageal Mucosa

Dutta

Agrawal

Girotra

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Introduction: Epidemiological studies suggest a protective role for β-carotene with several malignancies. Esophageal adenocarcinoma frequently arises from Barrett's esophagus (BE). We postulated that β-carotene therapy maybe protective in BE. Materials and Method: We conducted a prospective study in which 25 mg of β-carotene was administered daily for six-months to six patients. Each patient underwent upper endoscopy before and after therapy and multiple mucosal biopsies were obtained. Additionally, patients completed a gastroesophageal reflux disease (GERD) symptoms questionnaire before and after therapy and severity score was calculated. To study the effect of β-carotene at molecular level, tissue extracts of the esophageal mucosal biopsy were subjected to assessment of heat-shock protein 70 (HSP70). Results: A significant (p<0.05) reduction in mean GERD symptoms severity score from 7.0±2.4 to 2.7±1.7 following β-carotene therapy was noted. Measurement of Barrett's segment also revealed a significant reduction in mean length after therapy. In fact, two patients had complete disappearance of intestinal metaplasia. Furthermore, marked enhancement of HSP70 expression was demonstrated in biopsy specimens from Barrett's epithelium in four cases that were tested. Conclusions: Longterm β-carotene therapy realizes amelioration of GERD symptoms along with restitution of the histological and molecular changes in esophageal mucosa of patients with BE, associated with concurrent increase in mucosal HSP70 expression.

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Adenocarcinoma of the Esophagus and Barrett's Esophagus: A Population-Based Study

Cited by 242 publications

References 24 publications

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Risk factors for Barrett's esophagus: A case‐control study

Barrett's Esophagus and β-carotene Therapy: Symptomatic Improvement in GERD and Enhanced HSP70 Expression in Esophageal Mucosa

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