Top-100 Most-cited Articles on Esophageal Cancer: A Bibliometric Analysis

Ni, Wenjie; Sun, Lili; Tong, Fang

doi:10.21203/rs.3.rs-362326/v1

Cited by 1 publication

(1 citation statement)

References 45 publications

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“…Hence it is logical that surveillance of patients with established BE may prevent the poor outcomes associated with EAC by the detection of treatable premalignant or earlier stage localized malignant lesions, and this seems to have been borne out in some data[ 10 ]. Recent data from the United States show metastatic EAC at diagnosis has a 5-year survival rate of 4.3%, whereas local disease has a 40.3% 5-year survival[ 11 ]. This forms the rationale for Barrett’s surveillance programs that are recommended by international societies[ 12 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Barrett’s esophagus: Review of natural history and comparative efficacy of endoscopic and surgical therapies

Choi¹,

Sanagapalli²

2022

WJGO

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Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately, invasive neoplasia. Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates. This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier, and potentially curative stage. The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy (EET) for management of dysplastic and early neoplastic BE, and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence. This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage, and the effectiveness of interventions in attenuating the risk posed by its natural history. Key findings were as follows. Non-dysplastic Barrett’s is associated with extremely low risk of progression, and interventions cannot be justified. The annual risk of cancer progression in low grade dysplasia is between 1%-3%; EET can be offered though evidence for its benefit remains confined to highly select settings. High-grade dysplasia progresses to cancer in 5%-10% per year; EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication. Risk of nodal metastases in intramucosal cancer is 2%-4%, which is comparable to operative mortality rate, so EET is usually preferred. Submucosal cancer is associated with nodal metastases in 14%-41% hence surgery remains standard of care, except for select situations.

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