633P - Endoscopic Resection for Barrett's Esophagus, Uzbekistan expierence

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Oesophageal Cancer
Cancer Aetiology, Epidemiology, Prevention
Gastrointestinal Cancers
Presenter Sadykov Rasul
Citation Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369
Authors S. Rasul
  • Surgery Department, Tashkent Medical Academy, 100100 - Tashkent/UZ

Abstract

Background

In the treatment of esophageal dysplasia, particularly Barrett's esophagus, radical endoscopic resection (SRER) has shown its effectiveness. The purpose of this study was to evaluate the long-term results of treatment of Barrett's esophagus dysplasia after a successful SRER.

Methods

Patients who received SRER for BE ≤ 5 cm with high-grade dysplasia (HGD) or early cancer (EC) achieved complete elimination of intestinal metaplasia (CE-IM) and neoplasia (CE-neo). Primary outcomes: relapse of neoplasia (HGD/EC), recurrence of dysplasia (including indefinite dysplasia) and recurrence of endoscopically visible BE. METHODS: Patients who received SRER for BE ≤ 5 cm with high-grade dysplasia (HGD) or early cancer (EC) achieved complete elimination of intestinal metaplasia (CE-IM) and neoplasia (CE-neo). Primary outcomes: relapse of neoplasia (HGD/EC), recurrence of dysplasia (including indefinite dysplasia) and recurrence of endoscopically visible BE.

Results

Hidden Barrett's glands, IM in biopsy specimens obtained distal to the normal emerging neo-squamocolumnar compound, the need for re-treatment, and sustained by CE-IM and CE-neo at the last follow-up endoscopy. RESULTS: 76 patients were included (65 men, mean age 66 years, median BE C2M3). The median follow-up was 76 months. A repetition of neoplasia was observed in 1 patient (T1bN0M0) after 130 months of observation and was treated with medical surgery (annual frequency 0.22% per year of the patient's observation). Four patients had recurrent dysplasia (0.87% per patient-year of follow-up). Twelve patients had recurrent endoscopically visible BE after median follow-up for 22 months (2.6% for each subsequent patient-year of observation), mostly small islands or languages. Five patients were found to have one Barrett burial gland finding (1.1% per year of the patient's observation), and 27 patients (5.9% per year of the patient's observation) showed MI in biopsies only distal to the neo-squamocolumnar junction was not reproduced in 56%. Repeated treatment was performed in 9 patients. CE-IM and CE-neo (excluding IM in the neon-squamolecular compound) in the last endoscopic endoscopy were seen in 95% and 97% of patients, respectively.

Conclusions

This study presents the longest published data on SRER to date. 6-year results show that a successful SRER is a long-term therapy for BE ≤ 5 cm with HGD/EC.

Clinical trial identification

Legal entity responsible for the study

Tashkent Medical Academy

Funding

None

Disclosure

All authors have declared no conflicts of interest.