No risk factors for progression of low-grade dysplasia found in patients with Barrett's esophagus

A multicenter outcomes research project found no risk factors for progression of low-grade dysplasia in patients with Barrett’s esophagus.

Researchers concluded that patients with low-grade dysplasia and Barrett’s esophagus have a low annual incidence of esophageal adenocarcinoma, similar to nondysplastic Barrett’s esophagus.

The team investigated the incidence of both high-grade dysplasia and esophageal adenocarcinoma and compared progression in patients with various forms of low-grade dysplasia. Researchers also examined, among expert pathologists, the effects of consensus diagnosis of low-grade dysplasia on progression rates to high-grade dysplasia and esophageal adenocarcinoma.

“There is significant interobserver variation in diagnosis, even among expert pathologists,” the study authors said.

Six of the 210 study patients developed esophageal adenocarcinoma (incidence of 0.44% per year), and 21 patients developed high-grade dysplasia (incidence of 1.6% per year). Researchers found no links between prevalent, incident or persistent low-grade dysplasia with progression rates.

“Given these low rates of progression to [esophageal adenocarcinoma] and that surveillance did identify early-stage cancers, routine endoscopic ablation of all patients with [low-grade dysplasia] would be difficult to justify,” the study authors wrote.

Disclosure: The researchers report no relevant financial disclosures.