Barrett’s Esophagus after Bimodality Therapy in Patients with Esophageal Adenocarcinoma

Abstract

Introduction: Barrett’s esophagus (BE) may be present in patients with esophageal adenocarcinoma (EAC) after bimodality therapy (BMT). There is no specific guidance for follow-up of these patients with regard to the presence of BE or dysplasia. In this study, we assessed the outcomes of patients who, after BMT, had BE and those who did not. Method: Patients with EAC who had BMT were identified and analyzed retrospectively in two groups, with and without BE. We compared patient characteristics and outcome variables (local, distant, and no recurrence). Results: Of 228 patients with EAC, 68 (29.8%) had BE before BMT. Ninety-eight (42.9%) had BE after BMT, and endoscopic intervention was done in 11 (11.2%). With a median follow-up of 37 months, the presence of post-BMT BE was not significantly associated with overall survival (OS) and local recurrence-free survival (LRFS). Similarly, endoscopic intervention was not significantly associated with OS and LRFS. Fifty (73.5%) patients with BE before BMT had BE after BMT (p < 0.0001). Conclusion: The presence of BE after BMT was not associated with increased risk of local recurrence. The local recurrence rate was not influenced by endoscopic intervention. Prospective studies are warranted to generate guidance for intervention, if necessary, for this group of EAC patients.

Systematic review with meta‐analysis: prevalence of prior and concurrent Barrett's oesophagus in oesophageal adenocarcinoma patients

“…A total of 69 studies met the eligibility criteria and included 33 002 patients with OAC from 53 studies and 2712 with OGJAC from 28 studies. These studies were published from 1978 to 2019 and were conducted in US/Canada (n = 25, 36.2%), 7,17,18,20‐41 Europe (n = 30, 43.5%), 42‐71 Asia (n = 11, 15.9%), 72‐82 Africa (n = 1, 1.4%), 83 South America (n = 1, 1.4%) 84 or Australia (n = 1, 1.4%) 85 and included 55 single‐centre (79.7%), 7 multi‐centre (10.1%) and seven population‐based studies (10.1%) (Tables 1 and 2). OAC and OGJAC determination was made using surgical or endoscopic specimens (n = 59 studies), diagnosis codes (n = 3 studies) or cancer registry (n = 7 studies).…”