Barrett's Registry Collaboration of academic centers in Ireland reveals high progression rate of low-grade dysplasia and low risk from nondysplastic Barrett's esophagus : report of the RIBBON network
© The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
Barrett's esophagus (BE) is the main pathological precursor of esophageal adenocarcinoma (EAC). Progression to high-grade dysplasia (HGD) or EAC from nondysplastic BE (NDBE), low-grade dysplasia (LGD) and indefinite for dysplasia (IND) varies widely between population-based studies and specialized centers for many reasons, principally the rigor of the biopsy protocol and the accuracy of pathologic definition. In the Republic of Ireland, a multicenter prospective registry and bioresource (RIBBON) was established in 2011 involving six academic medical centers, and this paper represents the first report from this network. A detailed clinical, endoscopic and pathologic database registered 3,557 patients. BE was defined strictly by both endoscopic evidence of Barrett's epithelium and the presence of specialized intestinal metaplasia (SIM). A prospective web-based database was used to gather information with initial and follow-up data abstracted by a data manager at each site. A total of 2,244 patients, 1,925 with no dysplasia, were included with complete follow-up. The median age at diagnosis was 60.5 with a 2.1:1 male to female ratio and a median follow-up time of 2.7 years (IQR 1.19-4.04), and 6609.25 person years. In this time period, 125 (5.57%) progressed to HGD/EAC, with 74 (3.3%) after 1 year of follow-up and 38 (1.69%) developed EAC, with 20 (0.89%) beyond 1 year. The overall incidence of HGD/EAC was 1.89% per year; 1.16% if the first year is excluded. The risk of progression to EAC alone overall was 0.57% per year, 0.31% excluding the first year, and 0.21% in the 1,925 patients who had SIM alone at diagnosis. Low-grade dysplasia (LGD) progressed to HGD/EAC in 31% of patients, a progression rate of 12.96% per year, 6.71% with the first year excluded. In a national collaboration of academic centers in Ireland, the progression rate for NDBE was similar to recent population studies. Almost one in two who progressed was evident within 1 year. Crucially, LGD diagnosed and confirmed by specialist gastrointestinal pathologists represents truly high-risk disease, highlighting the importance of expertise in diagnosis and management, and providing indirect support for ablative therapies in this context.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
|---|---|
| Enthalten in: |
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus - 33(2020), 10 vom: 12. Okt. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
O'Byrne, Lisa M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Barrett's esophagus |
|---|
| Anmerkungen: |
Date Completed 28.07.2021 Date Revised 28.07.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/dote/doaa009 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM307799468 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM307799468 | ||
| 003 | DE-627 | ||
| 005 | 20231225130343.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/dote/doaa009 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1025.xml |
| 035 | |a (DE-627)NLM307799468 | ||
| 035 | |a (NLM)32193532 | ||
| 035 | |a (PII)doaa009 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a O'Byrne, Lisa M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Barrett's Registry Collaboration of academic centers in Ireland reveals high progression rate of low-grade dysplasia and low risk from nondysplastic Barrett's esophagus |b report of the RIBBON network |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.07.2021 | ||
| 500 | |a Date Revised 28.07.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a Barrett's esophagus (BE) is the main pathological precursor of esophageal adenocarcinoma (EAC). Progression to high-grade dysplasia (HGD) or EAC from nondysplastic BE (NDBE), low-grade dysplasia (LGD) and indefinite for dysplasia (IND) varies widely between population-based studies and specialized centers for many reasons, principally the rigor of the biopsy protocol and the accuracy of pathologic definition. In the Republic of Ireland, a multicenter prospective registry and bioresource (RIBBON) was established in 2011 involving six academic medical centers, and this paper represents the first report from this network. A detailed clinical, endoscopic and pathologic database registered 3,557 patients. BE was defined strictly by both endoscopic evidence of Barrett's epithelium and the presence of specialized intestinal metaplasia (SIM). A prospective web-based database was used to gather information with initial and follow-up data abstracted by a data manager at each site. A total of 2,244 patients, 1,925 with no dysplasia, were included with complete follow-up. The median age at diagnosis was 60.5 with a 2.1:1 male to female ratio and a median follow-up time of 2.7 years (IQR 1.19-4.04), and 6609.25 person years. In this time period, 125 (5.57%) progressed to HGD/EAC, with 74 (3.3%) after 1 year of follow-up and 38 (1.69%) developed EAC, with 20 (0.89%) beyond 1 year. The overall incidence of HGD/EAC was 1.89% per year; 1.16% if the first year is excluded. The risk of progression to EAC alone overall was 0.57% per year, 0.31% excluding the first year, and 0.21% in the 1,925 patients who had SIM alone at diagnosis. Low-grade dysplasia (LGD) progressed to HGD/EAC in 31% of patients, a progression rate of 12.96% per year, 6.71% with the first year excluded. In a national collaboration of academic centers in Ireland, the progression rate for NDBE was similar to recent population studies. Almost one in two who progressed was evident within 1 year. Crucially, LGD diagnosed and confirmed by specialist gastrointestinal pathologists represents truly high-risk disease, highlighting the importance of expertise in diagnosis and management, and providing indirect support for ablative therapies in this context | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Barrett's esophagus | |
| 650 | 4 | |a dysplasia | |
| 650 | 4 | |a early esophageal cancer | |
| 650 | 4 | |a endoscope | |
| 650 | 4 | |a esophageal malignancy | |
| 650 | 4 | |a high-grade dysplasia | |
| 700 | 1 | |a Witherspoon, Jolene |e verfasserin |4 aut | |
| 700 | 1 | |a Verhage, Roy J J |e verfasserin |4 aut | |
| 700 | 1 | |a O'Brien, Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Muldoon, Cian |e verfasserin |4 aut | |
| 700 | 1 | |a Ryan, Ciara |e verfasserin |4 aut | |
| 700 | 1 | |a Buckley, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Murphy, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Reynolds, Rob |e verfasserin |4 aut | |
| 700 | 1 | |a Patchett, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Kay, Elaine |e verfasserin |4 aut | |
| 700 | 1 | |a Azam, Halsema |e verfasserin |4 aut | |
| 700 | 1 | |a Robb, William |e verfasserin |4 aut | |
| 700 | 1 | |a Arumugasamy, Mayilone |e verfasserin |4 aut | |
| 700 | 1 | |a Mathuna, Padraic Mc |e verfasserin |4 aut | |
| 700 | 1 | |a Leyden, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Gargan, Siobhan |e verfasserin |4 aut | |
| 700 | 1 | |a Doherty, Glen |e verfasserin |4 aut | |
| 700 | 1 | |a Sheahan, Kieran |e verfasserin |4 aut | |
| 700 | 1 | |a Collins, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a Nath, Amar |e verfasserin |4 aut | |
| 700 | 1 | |a O'Sullivan, Jacintha |e verfasserin |4 aut | |
| 700 | 1 | |a Donohoe, Claire L |e verfasserin |4 aut | |
| 700 | 1 | |a Ravi, Narayanasamy |e verfasserin |4 aut | |
| 700 | 1 | |a O'Toole, Dermot |e verfasserin |4 aut | |
| 700 | 1 | |a Reynolds, John V |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus |d 1996 |g 33(2020), 10 vom: 12. Okt. |w (DE-627)NLM087786362 |x 1442-2050 |7 nnns |
| 773 | 1 | 8 | |g volume:33 |g year:2020 |g number:10 |g day:12 |g month:10 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/dote/doaa009 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 33 |j 2020 |e 10 |b 12 |c 10 | ||