Barrett's esophagus natural history, complications and prognosis: Difference between revisions

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Revision as of 15:35, 5 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amresh Kumar MD [2]

Overview

Common complications of Barrett's esophagus include esophageal carcinoma, esophageal stricture and esophageal ulcers.

Natural History, Complications, and Prognosis

Natural History

An increased risk of esophageal cancer. Follow-up endoscopy to look for dysplasia or cancer is often advised.

The symptoms of Barrett's esophagus usually develop in the fifth/sixth decade of life, and start with symptoms of GERD such as heartburn, regurgitation and dysphagia.
If left untreated, 0.1% to 0.4% of patients per year with Barrett's esophagus may progress to develop esophageal adenocarcinoma ^[1]^[2]^[3]^[4]^[5].

Complications

Common complications of Barrett's esophagus include:

Progression

From low-grade dysplasia to high-grade dysplasia or esophageal adenocarcinoma: 0.5 to 13.4% per year
From high-grade dysplasia to cancer: 6% per year.^[8]

Prognosis

Prognosis is generally good for Barrett's esophagus, but if it is associated with esophageal adenocarcinoma then 5 year survival rate of patients with Barrett's esophagus is approximately 20%<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.

References

↑ Drewitz DJ, Sampliner RE, Garewal HS (1997). "The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years". Am J Gastroenterol. 92 (2): 212–5. PMID 9040193.
↑ Eckardt VF, Kanzler G, Bernhard G (2001). "Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation". Am J Med. 111 (1): 33–7. PMID 11448658.
↑ Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P (2008). "Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis". Gastrointest Endosc. 67 (3): 394–8. doi:10.1016/j.gie.2007.07.019. PMID 18045592.
↑ Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE (2006). "Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus". Clin Gastroenterol Hepatol. 4 (5): 566–72. doi:10.1016/j.cgh.2006.03.001. PMID 16630761.
↑ Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S; et al. (2012). "The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis". Gut. 61 (7): 970–6. doi:10.1136/gutjnl-2011-300730. PMID 21997553.
↑ Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P (2011). "Incidence of adenocarcinoma among patients with Barrett's esophagus". N Engl J Med. 365 (15): 1375–83. doi:10.1056/NEJMoa1103042. PMID 21995385.
↑ ^7.0 ^7.1 Milind R, Attwood SE (2012). "Natural history of Barrett's esophagus". World J Gastroenterol. 18 (27): 3483–91. doi:10.3748/wjg.v18.i27.3483. PMC 3400849. PMID 22826612.
↑ Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (2011). "American Gastroenterological Association medical position statement on the management of Barrett's esophagus". Gastroenterology. 140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030. PMID 21376940. Unknown parameter |month= ignored (help)

Template:WH Template:WS

[pmid9040193-1] Drewitz DJ, Sampliner RE, Garewal HS (1997). "The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years". Am J Gastroenterol. 92 (2): 212–5. PMID 9040193.

[pmid11448658-2] Eckardt VF, Kanzler G, Bernhard G (2001). "Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation". Am J Med. 111 (1): 33–7. PMID 11448658.

[pmid18045592-3] Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P (2008). "Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis". Gastrointest Endosc. 67 (3): 394–8. doi:10.1016/j.gie.2007.07.019. PMID 18045592.

[pmid16630761-4] Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE (2006). "Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus". Clin Gastroenterol Hepatol. 4 (5): 566–72. doi:10.1016/j.cgh.2006.03.001. PMID 16630761.

[pmid21997553-5] Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S; et al. (2012). "The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis". Gut. 61 (7): 970–6. doi:10.1136/gutjnl-2011-300730. PMID 21997553.

[pmid21995385-6] Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P (2011). "Incidence of adenocarcinoma among patients with Barrett's esophagus". N Engl J Med. 365 (15): 1375–83. doi:10.1056/NEJMoa1103042. PMID 21995385.

[pmid22826612-7] 7.0 ^7.1 Milind R, Attwood SE (2012). "Natural history of Barrett's esophagus". World J Gastroenterol. 18 (27): 3483–91. doi:10.3748/wjg.v18.i27.3483. PMC 3400849. PMID 22826612.

[pmid21376940-8] Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (2011). "American Gastroenterological Association medical position statement on the management of Barrett's esophagus". Gastroenterology. 140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030. PMID 21376940. Unknown parameter |month= ignored (help)

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@@ Line 25: / Line 25: @@
 ==Prognosis==
-*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
+*Prognosis is generally good for Barrett's esophagus, but if it is associated with esophageal adenocarcinoma then 5 year survival rate of patients with Barrett's esophagus is approximately 20%<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
-*Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
-*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
-*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
-*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
 ==References==