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• W3208343256 abstract "Introduction: Endoscopic resection of early stage esophageal adenocarcinoma (EAC) has gained acceptance in recent years. While studies have demonstrated promising outcomes for short-term remission and recurrence, little is known about long-term recurrence and EAC-related mortality beyond 5 years. We assessed the outcomes of endoscopic eradication therapy (EET) for T1 EAC at 4 tertiary-referral academic institutions with follow up beyond 5 years. Methods: Patients with T1 EAC undergoing endoscopic mucosal resection (EMR) from 1995-2016 with at least 5 years follow up were identified in prospectively maintained databases. Patients with positive EMR margins who underwent esophagectomy within 90 days were excluded. Clinical characteristics were collected by chart review. Complete remission of intestinal metaplasia (CRIM) was defined as post-treatment surveillance endoscopy with negative biopsies. EAC recurrence was defined as early if within 2 years of endoscopic therapy. Results: A total of 98 patients met the specified inclusion criteria. Clinical characteristics are displayed in Table 1. The median follow-up was 8.76 years (interquartile range [IQR] 6.51-11.28) with all patients having at least 5 years of follow up. Patient outcomes are described in Figure 1. 94 patients (96%) achieved EAC remission, and 81 patients (83%) achieved CRIM. 12 patients (12.8%) experienced EAC recurrence. Of these, 6 (50%) recurred early (median 0.77 years; IQR, 0.74-0.81), and 6 (50%) recurred late (median 7.7 years; IQR, 5.2-8.77). In those who achieved EAC remission without CRIM, 3 (23%) recurred for an incidence rate of 2.49 cases per 100 patient-years (PY) (95% confidence interval [CI], 0.63-6.79) during a median of 1.76 years (IQR, 0.81-2.93). In comparison, 9 (11%) CRIM patients had EAC recurrence, for an incidence of 1.17 cases per 100 PY (95% CI, 0.57-2.14) during a median of 5.2 years (IQR, 0.75-8.58). Overall, 5-year EAC recurrence rate was 5.3% (5 patients). 4 patients died from recurrent EAC – 2 each from early (mean 1.27 years) and late (mean 7 years) recurrence. Conclusion: EET for T1 EAC achieves a high rate of cancer remission with excellent overall survival. While recurrence is overall uncommon, half of all EAC recurrences occurred late ( >2 years), emphasizing the importance of surveillance even when early recurrence is not observed. A higher incidence of EAC recurrence was observed in patients who did not achieve CRIM, suggesting that CRIM should be considered the most significant clinical endpoint.Table 1.: Clinical characteristics of the study population.Figure 1.: Flowchart." @default.
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• W3208343256 date "2021-10-01" @default.
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• W3208343256 title "S356 Long-Term (> 5 Year) Outcomes of Endoscopic Resection for T1 Esophageal Adenocarcinoma: A Multicenter Cohort Study" @default.
• W3208343256 doi "https://doi.org/10.14309/01.ajg.0000773896.61781.22" @default.
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