Risk of Esophageal Cancer in Achalasia: A Matched Cohort Study Using the Nationwide Veterans Affairs Achalasia Cohort

Low, Eric E.; Demb, Joshua; Shah, Shailja C.; Liu, Lin; Bustamante, Ranier; Yadlapati, Rena; Gupta, Samir

doi:10.14309/ajg.0000000000002591

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…Going forward, we plan to perform annual endoscopic surveillance for both achalasia and BE, especially that his risk of progression may be higher now after LES myotomy and the theoretical increase in esophageal squamous carcinoma in the setting of achalasia. 12 The result of TissueCypher would not have changed our management plan. In fact, the patient underwent Heller myotomy with HH repair and Dor fundoplication before the result of his TissueCypher was available.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Achalasia and Barrett's Esophagus: A Rare Coincidence

Altfillisch,

Mok,

Hamo

et al. 2024

ACG Case Rep J

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The pathophysiologies of achalasia and gastroesophageal reflux disease with Barrett's esophagus are highly distinct, though the clinical signs and symptoms of both are highly overlapped. The concomitant development of both achalasia and Barrett's esophagus is rare. We describe a case of a patient with a concomitant diagnosis of both pathologies and further explain the epidemiology of carrying both diseases simultaneously.

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Section: Discussionmentioning

confidence: 99%

Concomitant Achalasia and Barrett's Esophagus: A Rare Coincidence

Altfillisch,

Mok,

Hamo

et al. 2024

ACG Case Rep J

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Measuring and improving quality in esophageal care and swallowing disorders

Reddy,

Lee,

Leiman

2024

Diseases of the Esophagus

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Summary Evaluating clinical care through quality-related metrics is increasingly common. There are now numerous quality statements and indicators related to the medical management of benign and pre-malignant esophageal diseases. Expert consensus leveraging evidence-based recommendations from published society guidelines has been the most frequently used basis for developing esophageal quality statements. While surgical care of patients with esophageal malignancies, including squamous cell carcinoma, has also been developed, those related to benign esophageal disease now include domains of diagnosis, treatment, and monitoring for gastroesophageal reflux disease, eosinophilic esophagitis (EoE), achalasia, and Barrett’s esophagus (BE). Several recent studies evaluating adherence to quality metrics affirm substantial variation in practice patterns with opportunities for improvement in care across esophageal diseases. In particular, patient education regarding treatment options in achalasia, frequency of esophageal biopsies among patients with dysphagia to evaluate for EoE, and endoscopic evaluation within a BE segment are areas identified to have need for improvement. As the management of esophageal diseases becomes more complex and interdisciplinary, adherence to quality metrics may be a source of standardization and improvement in delivery and ultimately patient outcomes. Indeed, the development of national quality databases has resulted in a significant growth in the use of these metrics for quality improvement activities and may form the basis for future inclusion in quality reporting and payment programs.

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Research gap in esophageal achalasia: a narrative review

Savarino,

Salvador,

Ghisa

et al. 2024

Diseases of the Esophagus

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Summary In recent years, new translational evidence, diagnostic techniques, and innovative therapies have shed new light on esophageal achalasia and revamped the attention on this relatively rare motility disorder. This narrative review aims to highlight the most recent progress and the areas where further research is needed. The four senior authors identified five topics commonly discussed in achalasia management: i.e. pathogenesis, role of functional lumen imaging probe in the diagnostic flow chart of achalasia, how to define the outcome of achalasia treatments, how to manage persistent chest pain after the treatment, and if achalasia patients’ may benefit from a regular follow-up. We searched the bibliographic databases to identify systematic reviews, meta-analyses, randomized control trials, and original research articles in English up to December 2023. We provide a summary with the most recent findings in each of the five topics and the critical points where to address future research, such as the immune-genetic patterns of achalasia that might explain the transition among the different phenotypes, the need for a validated clinical definition of treatment success, the use of neuromodulators to manage chest pain, and the need for identifying achalasia patients at risk for cancer and who may benefit of long-term follow-up. Although undoubtedly, progress has been made on the definition and management of achalasia, unmet needs remain. Debated aspects range from mechanistic insights, symptoms, objective measure relationships, and accurate clinical responses to therapeutic interventions. Translational research is eagerly awaited to answer these unresolved questions.

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Risk of Esophageal Cancer in Achalasia: A Matched Cohort Study Using the Nationwide Veterans Affairs Achalasia Cohort

Cited by 3 publications

References 39 publications

Concomitant Achalasia and Barrett's Esophagus: A Rare Coincidence

Concomitant Achalasia and Barrett's Esophagus: A Rare Coincidence

Measuring and improving quality in esophageal care and swallowing disorders

Research gap in esophageal achalasia: a narrative review

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