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Endoscopic surveillance improves detection of, survival in oesophageal adenocarcinoma

05 Jun 2018

Active endoscopic surveillance in patients with Barrett’s oesophagus (BE) promotes detection of earlier-stage oesophageal adenocarcinoma (EAC) and may result in a small survival benefit, according to a recent meta-analysis.

Pooled analysis of four cohort studies showed that regular vs no/incomplete surveillance was associated with significantly lower EAC-related mortality (risk ratio [RR], 0.60; 95 percent CI, 0.50–0.71; p<0.00001). No significant heterogeneity was detected, but adjustment for disease stage and treatment attenuated the effect of surveillance (hazard ratio [HR], 0.72; 0.51–1.01).

Regular surveillance also led to significantly decreased all-cause mortality (HR, 0.75; 0.59–0.94). Minimal heterogeneity in the data was observed.

A subsequent analysis of studies grouped according to prior BE diagnosis confirmed these findings. Those with BE histories had significantly lower risks of EAC-related mortality (RR, 0.73; 0.57–0.94; p=0.02) and all-cause mortality (OR, 0.59; 0.45–0.76; p<0.0001).

In addition, patients who received regular surveillance were significantly more likely to be diagnosed with early-stage cancer (stage 0 or I) than those who received inadequate or no surveillance (RR, 2.11; 1.08–4.11).

In contrast, regular surveillance did not appear to have a significant impact on intervention, as both patient groups who received and did not receive active surveillance showed the same likelihoods of oesophagectomy (RR, 1.47; 0.92–2.33).

Accessing the databases of Medline, Cochrane CENTRAL, Web of Science, PubMed, Scopus and Ovid Embase, researchers identified prospective or retrospective studies focused on the effects of endoscopic surveillance of EAC-related outcomes.

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Most Read Articles
Jairia Dela Cruz, 6 days ago
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
Tristan Manalac, 6 days ago
Less than 15 percent of Singaporean adolescents get the recommended 8–10 hours of sleep on a school night, reports a recent study, noting that such short sleep duration is linked to symptoms of depression, overweight or obesity, and poorer self-rated health.
04 Jan 2019
Obstructive sleep apnoea may increase the risk of male-pattern baldness in men with a family history of hair loss, and this association appears to be mediated by low serum transferrin saturation levels related to hypoxia, a study suggests.
6 days ago
Airway type 2 inflammation remains persistent in many asthmatics on inhaled corticosteroids, a new study has shown. These patients tend to be older and have a more severe disease.