Benefit of baseline cytometry for surveillance of patients with Barrett’s esophagus

Vogt, Nicole P.; Schönegg, René; Gschossmann, Juergen M.; Borovicka, Jan

doi:10.1007/s00464-009-0741-7

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…Four studies were population-based (median follow-up, 5.0 years), 2,3,9,21 4 were multicenter studies (median follow-up, 4.7 years), 27,29,39,42 and the remaining were single-center studies (median follow-up, 4.8 years). 19,20,22–26,28,30–38,40,41 Most studies reported or permitted a missed vs incident cutoff of exactly 12 months to be applied, with the exception of 2 studies reporting cutoffs of 9 and 6 months, 32,39 and 1 study for which only a cutoff of 14 months could be applied. 24 In these 3 studies, EAC (and HGD-EAC) detected before and after their respective cutoffs were classified as missed and incident, respectively.…”

Section: Resultsmentioning

confidence: 99%

Magnitude of Missed Esophageal Adenocarcinoma After Barrett’s Esophagus Diagnosis: A Systematic Review and Meta-analysis

et al. 2016

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Background & Aims A proportion of patients with Barrett's esophagus (BE) are diagnosed with esophageal adenocarcinoma (EAC) within 1 year of an endoscopic examination that produced negative findings. These cases of missed cancers have not been well studied, despite current surveillance strategies for BE. We performed a systematic review and meta-analysis to determine the magnitude of missed EAC in cohorts of patients with BE. Methods We searched MEDLINE, EMBASE, and Web of Science from their inception to May 31, 2015 to identify cohort studies of adults with BE (baseline nondysplastic BE ± BE with low-grade dysplasia) and at least a 3-year follow-up period, providing data on missed and incident EACs (diagnosed within 1 year and diagnosed more than 1 year after the initial endoscopy in which BE was diagnosed, respectively). The main outcome measure was pooled proportion of missed and incident EACs (of all EACs detected after initial endoscopy) among BE cohorts, using a random effects model. Results In a metaanalysis of 24 studies reporting on 820 missed and incident EACs, 25.3% were classified as missed (95% confidence interval: 16.4%–36.8%) and 74.7% as incident EACs (95% CI: 63.2%–83.6%), although there was substantial heterogeneity among studies (I2 = 74%). When the analysis was restricted to nondysplastic BE cohorts (15 studies), 23.9% of EACs were classified as missed (95% confidence interval: 15.3%–35.4%; I2 = 0%). In a meta-analysis of 10 studies with follow-up periods of ≥5 years (a total of 239 EACs), 22.0% were classified as missed (95% confidence interval: 8.7%–45.5%), with substantial heterogeneity (I2 = 68%). Conclusions Among adults with nondysplastic BE (or BE with low-grade dysplasia) at their index endoscopy and at least a 3-year follow-up period, 25% of EACs are diagnosed within 1 year after the index endoscopy. Additional resources should be allocated to detect missed EAC.

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Section: Resultsmentioning

confidence: 99%

Magnitude of Missed Esophageal Adenocarcinoma After Barrett’s Esophagus Diagnosis: A Systematic Review and Meta-analysis

et al. 2016

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“…After applying our inclusion and exclusion criteria, the search was narrowed to 90 studies, all of which were reviewed in detail. Ultimately, 10 studies were included for analysis 18,28‐36 . The flowchart of the article search and selection process is outlined in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…There was considerable heterogeneity in the pooled analyses of neoplasia detection rate (I 2 = 97%) and post‐endoscopy Barrett's neoplasia rate (I 2 = 96%). The pooled expanded neoplasia detection rate, based on data available from nine studies, was 14.4% (95% CI: 11.2%‐18.3%, I 2 = 98%) 18,29‐36 …”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: neoplasia detection rate and post‐endoscopy Barrett's neoplasia in Barrett's oesophagus

Hamade

Kamboj

Krishnamoorthi

et al. 2021

Aliment Pharmacol Ther

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Summary Background Neoplasia detection rate, the proportion of Barrett's oesophagus patients with high‐grade dysplasia or oesophageal adenocarcinoma detected at index surveillance endoscopy has been proposed as a quality metric. However, the correlation between neoplasia detection rate and a clinically relevant outcome like post‐endoscopy Barrett's neoplasia remains unknown. Post‐endoscopy Barrett's neoplasia refers to the rate of high‐grade dysplasia or oesophageal adenocarcinoma on repeat endoscopy within one year of an index screening examination revealing non‐dysplastic Barrett's oesophagus or low‐grade dysplasia. Aim To assess correlation between neoplasia detection rate and post‐endoscopy Barrett's neoplasia. Methods We performed a systematic search of multiple databases from date of inception to June 2021 to identify cohort studies reporting both neoplasia detection rate and post‐endoscopy Barrett's neoplasia. Data from each study were pooled using a random effects model, and their correlation assessed using meta‐regression. Heterogeneity was assessed and a priori planned subgroup analyses were conducted. Results Ten studies with 27 894 patients with Barrett's oesophagus were included. The pooled neoplasia detection rate and post‐endoscopy Barrett's neoplasia were 5.0% (95% CI: 3.4%‐7.1%, I2 = 97%) and 19.6% (95% CI: 10.1%‐34.7%, I2 = 96%), respectively. Meta‐regression revealed a statistically significant inverse relationship between the two variables (coefficient −3.50, 95% CI: −4.63 to −2.37, P < 0.01). With every 1% increase of neoplasia detection rate, post‐endoscopy Barrett's neoplasia decreased by 3.50%. Heterogeneity was high despite adjusting for study quality and performing several subgroup analyses. Conclusion We observed a statistically significant inverse correlation between neoplasia detection rate and post‐endoscopy Barrett's neoplasia. Additional studies are needed to further validate this correlation.

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“…Our search strategy yielded a total 2482 citations, of which 14 citations fulfilled our inclusion criteria for meta‐analysis (Figure ) . Thirteen of these studies cumulatively reported 603 prevalent and incident oesophageal adenocarcinomas in 9657 patients with Barrett’'s (Table ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: prevalent vs. incident oesophageal adenocarcinoma and high‐grade dysplasia in Barrett's oesophagus

Visrodia

Singh

Krishnamoorthi

et al. 2016

Aliment Pharmacol Ther

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Benefit of baseline cytometry for surveillance of patients with Barrett’s esophagus

Cited by 13 publications

References 13 publications

Magnitude of Missed Esophageal Adenocarcinoma After Barrett’s Esophagus Diagnosis: A Systematic Review and Meta-analysis

Magnitude of Missed Esophageal Adenocarcinoma After Barrett’s Esophagus Diagnosis: A Systematic Review and Meta-analysis

Systematic review with meta‐analysis: neoplasia detection rate and post‐endoscopy Barrett's neoplasia in Barrett's oesophagus

Systematic review with meta‐analysis: prevalent vs. incident oesophageal adenocarcinoma and high‐grade dysplasia in Barrett's oesophagus

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