M1995 InterSPORE/EDRN Barrett's Esophagus (BE) Study: Interim Report of a Multicenter Case-Control Study of Progressors to High-Grade Dysplasia/Adenocarcinoma vs. Nonprogressors

Sampliner, Richard E.; Wang, Kenneth K.; Shaheen, Nicholas J.; Wolfsen, Herbert C.; Wang, Jean S.; Meltzer, Stephen J.; Washington, Kay; Gu, Jesse T.; Zheng, Yingye

doi:10.1016/s0016-5085(08)62088-0

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“…Analysis from other larger cohorts has also not identified increasing age as a risk factor for progression (18,19). A recent preliminary report from a multicenter database comparing progressors and non progressors reported that the mean age at initiation of surveillance in progressors (77.1 years) was significantly greater than in non progressors (68.6 years) (24). In conclusion, there is insufficient data at this time to support age as a risk factor in the progression to HGD/EAC.…”

Section: Predictors Of Progression In Barrett’s Esophagusmentioning

confidence: 99%

Predictors of Progression in Barrett's Esophagus: Current Knowledge and Future Directions

Prasad

Bansal

Sharma

et al. 2010

American Journal of Gastroenterology

107

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Barrett’s esophagus is the strongest risk for esophageal adenocarcinoma (EAC), a malignancy with persistently poor long-term outcomes. EAC is thought to develop through progression of metaplasia to dysplasia to invasive carcinoma. Identification of factors predicting progression to EAC would help in focusing surveillance, chemoprevention or ablation at those deemed to be at highest risk of progression. We performed a comprehensive review of the literature and summarized current evidence on risk factors for progression in subjects with known BE. Clinical and demographic factors (age, male gender, length of BE segment) are associated with modestly increased odds of progression to EAC in some studies. Biomarkers such as aneuploidy and p53 loss of heterozygosity have been associated with increased risk of progression to high-grade dysplasia and / or EAC in single center prospective cohort studies. Promising newer techniques and markers have been recently reported with the potential to help risk stratify BE subjects. Development of a comprehensive BE risk progression score comprised of both clinical and biomarker variables should be the ultimate goal and can be achieved by multicenter prospective collaborative efforts. Though challenging, creation of such a score has the potential to improve outcomes and make the management of patients with BE more cost effective.

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Section: Predictors Of Progression In Barrett’s Esophagusmentioning

confidence: 99%