Risk of recurrence of Barrett’s esophagus after successful endoscopic therapy: Influence Statistics

Expert Impact

Concepts for which they have has direct influence: Endoscopic therapy , Recurrence crim , Hgd eac , Recurrence barrett esophagus , Barrett esophagus , Incidence recurrence , Complete remission .

Key People For Endoscopic Therapy

Top KOLs in the world
#1
Christian Ell
endoscopic resection photodynamic therapy small bowel
#2
Joseph Jao Yiu Joseph
gastric cancer hong kong helicobacter pylori
#3
Jacques M Devière
chronic pancreatitis pancreatic duct endoscopic treatment
#4
Nib Soehendra
endoscopic ultrasound chronic pancreatitis esophageal varices
#5
Peter B Cotton
chronic pancreatitis oddi dysfunction pancreas divisum
#6
Ernst Johan Kuipers
helicobacter pylori colorectal cancer atrophic gastritis

Risk of recurrence of Barrett’s esophagus after successful endoscopic therapy

Abstract

. BACKGROUND AND AIMS: Previous estimates of incidence of intestinal metaplasia (IM) recurrence after achieving complete remission of IM (CRIM) through endoscopic therapy of Barrett's esophagus (BE) have varied widely. We performed a systematic review and meta-analysis of studies to estimate an accurate recurrence risk after CRIM. METHODS: We performed a systematic search of multiple literature databases through June 2015 to identify studies reporting long-term follow-up after achieving CRIM through endoscopic therapy. Pooled incidence rate (IR) of recurrent IM, dysplastic BE, and high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC) per person-year of follow-up after CRIM was estimated. Factors associated with recurrence were also assessed. RESULTS: We identified 41 studies that reported 795 cases of recurrence in 4443 patients over 10,427 patient-years of follow-up. This included 21 radiofrequency ablation studies that reported 603 cases of IM recurrence in 3186 patients over 5741 patient-years of follow-up. Pooled IRs of recurrent IM, dysplastic BE, and HGD/EAC after radiofrequency ablation were 9.5% (95% CI, 6.7-12.3), 2.0% (95% CI, 1.3-2.7), and 1.2% (95% CI, .8-1.6) per patient-year, respectively. When all endoscopic modalities were included, pooled IRs of recurrent IM, dysplastic BE, and HGD/EAC were 7.1% (95% CI, 5.6-8.6), 1.3% (95% CI, .8-1.7), and .8% (95% CI, .5-1.1) per patient-year, respectively. Substantial heterogeneity was noted. Increasing age and BE length were predictive of recurrence; 97% of recurrences were treated endoscopically. CONCLUSIONS: The incidence of recurrence after achieving CRIM through endoscopic therapy was substantial. A small minority of recurrences were dysplastic BE and HGD/EAC. Hence, continued surveillance after CRIM is imperative. Additional studies with long-term follow-up are needed.