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Clinical characteristics of young patients with early Barrett’s neoplasia
BACKGROUND: Esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) may appear in young patients with Barrett’s esophagus (BE). However, characteristics of Barrett’s-related neoplasia in this younger population remain unknown. AIM: To identify clinical characteristics that differ between youn...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603815/ https://www.ncbi.nlm.nih.gov/pubmed/31293342 http://dx.doi.org/10.3748/wjg.v25.i24.3069 |
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author | Iwaya, Yugo Shimamura, Yuto Goda, Kenichi Rodríguez de Santiago, Enrique Coneys, John Gerard Mosko, Jeffrey D Kandel, Gabor Kortan, Paul May, Gary Marcon, Norman Teshima, Christopher |
author_facet | Iwaya, Yugo Shimamura, Yuto Goda, Kenichi Rodríguez de Santiago, Enrique Coneys, John Gerard Mosko, Jeffrey D Kandel, Gabor Kortan, Paul May, Gary Marcon, Norman Teshima, Christopher |
author_sort | Iwaya, Yugo |
collection | PubMed |
description | BACKGROUND: Esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) may appear in young patients with Barrett’s esophagus (BE). However, characteristics of Barrett’s-related neoplasia in this younger population remain unknown. AIM: To identify clinical characteristics that differ between young and old patients with early-stage Barrett’s-related neoplasia. METHODS: We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC (pT1) and HGD at a tertiary-referral center between 2001 and 2017. Baseline characteristics, drug and risk factor exposures, clinicopathological staging of EAC/HGD and treatment outcomes [complete eradication of neoplasia (CE-N), complete eradication of intestinal metaplasia (CE-IM), recurrence of neoplasia and recurrence of intestinal metaplasia] were retrieved. Multivariate analyses were performed to identify factors that differed significantly between older and younger (≤ 50 years) patients. RESULTS: We identified 450 patients with T1 EAC and HGD (74% and 26%, respectively); 45 (10%) were ≤ 50 years. Compared to the older group, young patients were more likely to present with ongoing gastroesophageal reflux disease (GERD) symptoms (55% vs 38%, P = 0.04) and to be obese (body mass index > 30, 48% vs 32%, P = 0.04). Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.04-3.85, P = 0.04] and to be obese (OR 2.06, 95%CI 1.07-3.98, P = 0.03) whereas the young group was less likely to have a smoking history (OR 0.39, 95%CI 0.20-0.75, P < 0.01) compared to the old group. However, there were no significant differences regarding tumor histology, CE-N, CE-IM, recurrence of neoplasia and recurrence of intestinal metaplasia (mean follow-up, 44.3 mo). CONCLUSION: While guidelines recommend BE screening in patients > 50 years of age, younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms. |
format | Online Article Text |
id | pubmed-6603815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-66038152019-07-10 Clinical characteristics of young patients with early Barrett’s neoplasia Iwaya, Yugo Shimamura, Yuto Goda, Kenichi Rodríguez de Santiago, Enrique Coneys, John Gerard Mosko, Jeffrey D Kandel, Gabor Kortan, Paul May, Gary Marcon, Norman Teshima, Christopher World J Gastroenterol Retrospective Study BACKGROUND: Esophageal adenocarcinoma (EAC) and high-grade dysplasia (HGD) may appear in young patients with Barrett’s esophagus (BE). However, characteristics of Barrett’s-related neoplasia in this younger population remain unknown. AIM: To identify clinical characteristics that differ between young and old patients with early-stage Barrett’s-related neoplasia. METHODS: We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC (pT1) and HGD at a tertiary-referral center between 2001 and 2017. Baseline characteristics, drug and risk factor exposures, clinicopathological staging of EAC/HGD and treatment outcomes [complete eradication of neoplasia (CE-N), complete eradication of intestinal metaplasia (CE-IM), recurrence of neoplasia and recurrence of intestinal metaplasia] were retrieved. Multivariate analyses were performed to identify factors that differed significantly between older and younger (≤ 50 years) patients. RESULTS: We identified 450 patients with T1 EAC and HGD (74% and 26%, respectively); 45 (10%) were ≤ 50 years. Compared to the older group, young patients were more likely to present with ongoing gastroesophageal reflux disease (GERD) symptoms (55% vs 38%, P = 0.04) and to be obese (body mass index > 30, 48% vs 32%, P = 0.04). Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms [odds ratio (OR) 2.00, 95% confidence interval (CI) 1.04-3.85, P = 0.04] and to be obese (OR 2.06, 95%CI 1.07-3.98, P = 0.03) whereas the young group was less likely to have a smoking history (OR 0.39, 95%CI 0.20-0.75, P < 0.01) compared to the old group. However, there were no significant differences regarding tumor histology, CE-N, CE-IM, recurrence of neoplasia and recurrence of intestinal metaplasia (mean follow-up, 44.3 mo). CONCLUSION: While guidelines recommend BE screening in patients > 50 years of age, younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms. Baishideng Publishing Group Inc 2019-06-28 2019-06-28 /pmc/articles/PMC6603815/ /pubmed/31293342 http://dx.doi.org/10.3748/wjg.v25.i24.3069 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Iwaya, Yugo Shimamura, Yuto Goda, Kenichi Rodríguez de Santiago, Enrique Coneys, John Gerard Mosko, Jeffrey D Kandel, Gabor Kortan, Paul May, Gary Marcon, Norman Teshima, Christopher Clinical characteristics of young patients with early Barrett’s neoplasia |
title | Clinical characteristics of young patients with early Barrett’s neoplasia |
title_full | Clinical characteristics of young patients with early Barrett’s neoplasia |
title_fullStr | Clinical characteristics of young patients with early Barrett’s neoplasia |
title_full_unstemmed | Clinical characteristics of young patients with early Barrett’s neoplasia |
title_short | Clinical characteristics of young patients with early Barrett’s neoplasia |
title_sort | clinical characteristics of young patients with early barrett’s neoplasia |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603815/ https://www.ncbi.nlm.nih.gov/pubmed/31293342 http://dx.doi.org/10.3748/wjg.v25.i24.3069 |
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