Optimized Surveillance Intervals Following Endoscopic Eradication of Dysplastic Barrett’s Esophagus: An International Cohort Study

Clinical Outcomes After Endoscopic Management of Low-Risk and High-Risk T1a Esophageal Adenocarcinoma: A Multicenter Study

“…The baseline characteristics of patients with low-risk and high-risk T1a EAC are summarized in Table 1 and generally did not vary significantly between the 2 groups. The high-risk group, however, had a numerically greater lesion size (median [IQR] 20 mm vs 15 [10][11][12][13][14][15][16][17][18][19][20] mm, P 5 0.25), statistically greater number of ER specimens with EAC during index EGD (median [IQR] 1 [1-2] vs 1 [1-1], P , 0.01), and numerically higher proportion of deeper layer involvement (muscularis mucosa) (48.9% vs 30.1%, P 5 0.15) and positive lateral margins (48.9% vs 30.1%, P 5 0.06). There was no difference between groups with median (IQR) number of follow-up EGD (low risk 7 [5][6][7][8][9][10][11][12], high risk 8 [5][6][7][8][9][10][11][12][13][14][15], P 5 0.22) and median (IQR) number of follow-up EUS studies (low risk 1 [1][2], high risk 2 [1-2], P 5 0.15).…”

“…Patients who are candidates for surgery participate in shared decision-making to weigh the risks and benefits of endoscopic therapy vs surgery. In all patients who pursue endoscopic management, after remission of EAC has been achieved, EET is continued until CRD and then CRIM has been achieved because this has been shown to decrease the risk of EAC and dysplasia recurrence (19,20), and then endoscopic surveillance is continued thereafter. In a recent study, we showed that neoplastic recurrence 5 years after successful EET of T1 EAC occurred in 8.3% of cases underscoring the importance of careful long-term surveillance (19).…”