Early-Onset Esophageal Adenocarcinoma Presents With Advanced-Stage Disease But Has Improved Survival Compared With Older Individuals

Kolb, Jennifer M.; Han, Samuel; Scott, Frank I.; Murphy, Caitlin C.; Hosokawa, Patrick; Wani, Sachin; Cook, Michael B.; Fox, Charlie; Friedman, Chloe; McCarter, Martin D.; Vajravelu, Ravy K.; Lieu, Christopher H.; Gleisner, Ana; Falk, Gary W.; Katzka, David A.

doi:10.1053/j.gastro.2020.08.002

Cited by 33 publications

(27 citation statements)

References 8 publications

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“…It indicates that EAC occurs earlier in Barrett’s esophagus patients, which may be partly due to detection bias, or that Barrett’s esophagus is developing in younger populations. However, concerns have been raised in current literature that Barrett’s esophagus is increasingly diagnosed in younger patients, but this does not seem to translate into an increase in EAC in young adults [ 33 ]. We also found that non-dysplastic columnar metaplasia patients who had their first biopsy taken 2007–2016 had lowest relative risk for EAC compared to patients enrolled earlier.…”

Section: Discussionmentioning

confidence: 99%

Esophageal abnormalities and the risk for gastroesophageal cancers—a histopathology-register-based study in Sweden

et al. 2022

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Background The poor survival of patients with gastroesophageal cancers may improve if additional esophageal precursor lesions to Barrett’s esophagus and squamous dysplasia are identified. We estimated the risk for gastroesophageal cancers among patients with various histopathological abnormalities in the esophagus, including Barrett’s esophagus, subdivided by histopathological types. Methods Histopathology data from esophageal biopsies obtained 1979–2014 were linked with several national population-based registers in Sweden. Patients were followed from 2 years after the first biopsy date until cancer, death, emigration, esophagectomy/gastrectomy or end of follow-up, 31st of December 2016, whichever came first. We estimated standardized incidence ratios (SIRs) as measures of relative risk with the Swedish general population as reference. Results In total 367 esophageal adenocarcinoma (EAC) cases were ascertained during 831,394 person-years of follow-up. The incidence rate (IR) for EAC was 0.1 per 1000 person-years for normal morphology, 0.2–0.5 for inflammatory changes, and 0.8–2.9 for metaplasia. The IR was 1.0 per 1000 person-years (95% confidence interval 0.7–1.3) among patients with non-dysplastic intestinal metaplasia, 0.9 (0.8–1.1) in non-dysplastic gastric/glandular metaplasia and 2.9 (2.0–4.2) among columnar metaplasia patients with low-grade dysplasia. The SIRs were 11.7 (95% confidence interval 8.6–15.5), 12.0 (10.0–14.2) and 30.2 (20.5–42.8), respectively. The SIRs for gastric cardia adenocarcinoma (GCA) were moderately elevated. Conclusions For the first time, we demonstrate that patients with esophageal inflammatory and other metaplastic abnormalities than Barrett’s esophagus have an increased risk of EAC and GCA compared to the general population. Moreover, patients with different histopathologic subtypes of Barrett’s esophagus have a comparable risk for EAC.

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Section: Discussionmentioning

confidence: 99%

Esophageal abnormalities and the risk for gastroesophageal cancers—a histopathology-register-based study in Sweden

et al. 2022

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“…Besides, some studies have reported that there was no distinction in the survival rate between young and elderly patients with EC, but young patients with EC have more advanced tumors and more malignant potential and invasiveness than older patients [ 6 ]. A relevant study had manifested that compared with elderly patients, while patients with early-onset esophageal adenocarcinoma (younger than 50 years) were a high proportion of advanced stages; they had a superior survival rate [ 7 ]. Furthermore, due to being often diagnosed at an advanced stage at the time of consultation, esophageal cancer has a poor prognosis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Construction and verification of prognostic nomogram for early-onset esophageal cancer

Liu

Wei

Shi

et al. 2021

Bosn J of Basic Med Sci

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This study aimed to build up nomogram models to evaluate overall survival (OS) and cancer-specific survival (CSS) in early-onset esophageal cancer (EOEC). Patients diagnosed with esophageal cancer (EC) from 2004 to 2015 were extracted from the Surveillance Epidemiology and End Results (SEER) database. Clinicopathological characteristics of younger versus older patients were compared, and survival analysis was performed in both groups. Independent related factors influencing the prognosis of EOEC were identified by univariate and multivariate Cox analysis, which were incorporated to construct a nomogram. The predictive capability of the nomogram was estimated by the concordance index (C-index), calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). A total of 534 younger and 17,243 older patients were available from the SEER database. Younger patients were randomly segmented into a training set (n=266) and a validation set (n=268). In terms of the training set, the C-index of the OS nomogram was 0.740 (95% CI: 0.707-0.773), and that of the CSS nomogram was 0.752 (95% CI: 0.719-0.785). In view of the validation set, the C-index of OS and CSS were 0.706 (95% CI: 0.671-0.741) and 0.723 (95%CI: 0.690-0.756), respectively. Calibration curves demonstrated the consistent degree of fit between actual and predicted values in nomogram models. From the perspective of DCA, the nomogram models were more beneficial than the tumor-node-metastasis (TNM) and the SEER stage for EOEC. In brief, the nomogram model can be considered as an individualized quantitative tool to predict the prognosis of EOEC patients to assist clinicians in making treatment decisions.

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“…As the incidence of esophageal adenocarcinoma increases in the United States, detection, diagnosis, and treatment for Barrett’s esophagus (BE) is even more critical. 1 BE-related neoplasia is managed by endoscopic eradication therapy, a strategy of endoscopic resection of any nodular or visible lesion and ablation for flat neoplasia. 2 Ablative modalities include radiofrequency ablation (RFA), argon plasma coagulation (APC), and cryoablation with either spray liquid nitrogen or balloon-based nitrous oxide therapy.…”

Section: Introductionmentioning

confidence: 99%

Hybrid argon plasma coagulation for Barrett’s esophagus

et al. 2021

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Early-Onset Esophageal Adenocarcinoma Presents With Advanced-Stage Disease But Has Improved Survival Compared With Older Individuals

Cited by 33 publications

References 8 publications

Esophageal abnormalities and the risk for gastroesophageal cancers—a histopathology-register-based study in Sweden

Esophageal abnormalities and the risk for gastroesophageal cancers—a histopathology-register-based study in Sweden

Construction and verification of prognostic nomogram for early-onset esophageal cancer

Hybrid argon plasma coagulation for Barrett’s esophagus

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