Clinical and pathological predictors of failure of endoscopic therapy for Barrett’s related high-grade dysplasia and early esophageal adenocarcinoma

State of the Art: Management of Barrett’s Esophagus Related Dysplasia and Neoplasia—Which Patient and What Therapy?

“…A retrospective study by Shimamura et al showed that long segment BE, older age, and lymphovascular invasion are poor predictors for achieving CRIM in patients with IMCa undergoing EMR followed by ablation. 41 In our recent study, we showed that high BMI and longer BE segment is a negative predictor in achieving CRIM in patient undergoing ESD/EMR followed by ablation. 42…”

Rio de Janeiro Global Consensus on Landmarks, Definitions, and Classifications in Barrett’s Esophagus: World Endoscopy Organization Delphi Study

“…Agreement: Aþ, 23%; A, 63%; U, 3%; D, 7%; Dþ, 3% Evidence: Very low Recommendation: Weak Long-segment BE, especially when >10 cm, is considered the strongest predictor of endoscopic treatment failure for CED and CEIM; greater age is also a factor associated with failure to achieve CEIM. 58 Although patients with a more extended baseline BE might need more than 4 RFA sessions, 59 most studies show that patients with nonnodular dysplastic BE 8 cm in length had 87% CEIM when receiving up to 4 RFA sessions. 60,61 Other factors associated with failure of BET include piecemeal resection, baseline HGD, no ablative therapy after endoscopic resection, >10 months until achieving a complete response, presence of multifocal neoplasia, and poor control of acid reflux.…”

Pathology Reporting of Esophagus Endoscopic Resections: Recommendations From the International Collaboration on Cancer Reporting

“…Pathologic examination of the ER specimen is important because it provides data that inform the likelihood of recurrence and prognosis of patients. 1 There is no internationally accepted standardized dataset for reporting pathologic parameters of early esophageal neoplasia and taking account of both squamous neoplasia and Barrett's esophagus-associated neoplasia. Following the fifth edition of the World Health Organization (WHO) Classification of Tumors of the Digestive System, the International Collaboration on Cancer Reporting (ICCR) developed a dataset that is summarized in this article.…”