Barrett’s esophagus intervention boosts disease-specific survival
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Barrett’s esophagus intervention effectively improved overall disease-specific survival, according to a presentation at the American College of Gastroenterology Virtual Annual Scientific Meeting.
“BE is a condition in which the squamous lining of the esophagus is replaced by intestinal type columnar epithelium and is the only recognized precursor to esophageal adenocarcinoma,” Yuri Hanada, MD, division of gastroenterology and hepatology at the Mayo Clinic, said. “Because the prognosis for esophageal cancer is quite poor, there is considerable interest in optimizing endoscopic surveillance, which aims to detect histologic changes that can be treated before progression occurs.”
In a retrospective cohort study, investigators analyzed adults receiving care in the Mayo Clinic BE unit for treatment modalities and their association with overall survival (median follow-up, 7.5 years). Study results showed older age (HR = 1.1; 95% CI, 1.1-1.1), higher Charlson comorbidity index (HR = 1.2; 95% CI, 1-1.3) and development of EAC during course of follow-up (HR = 1.8; 95% CI, 1.1-2.9) best predicted poor OS. Further, older age (HR = 1.1; 95% CI, 1-1.2) and development of EAC (HR = 13; 95% CI, 3.3-50) were also associated with poor disease-specific survival. Improved OS was associated with follow-up interventional treatment by radiofrequency ablation (HR = 0.6; 95% CI, 0.4-0.8) and thermal coagulation (HR = 0.6; 95% CI, 0.5-0.9).
“Long-term outcomes of our Barrett’s therapy program, without use of surrogate endpoints, highlight the efficacy of such a program in terms of overall and disease-specific survival,” Hanada concluded. “Lastly, disease-specific survival is, as expected, determined primarily by development of esophageal cancer during the course of follow-up in patient-related factors.”
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