Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus: A multicenter cohort study

Preetika Sinh, Rajeswari Anaparthy, Patrick E. Young, Srinivas Gaddam, Prashanthi Thota, Gokulakrishnan Balasubramanian, Mandeep Singh, April D. Higbee, Sachin Wani, Neil Gupta, Amit Rastogi, Sharad C. Mathur, Ajay Bansal, John D. Horwhat, Brooks D. Cash, Gary W. Falk, David Lieberman, John J. Vargo, Richard E. Sampliner, Prateek Sharma

Research output: Contribution to journalArticle

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Abstract

Background and study aim: Data are limited on the natural history of patients with Barrett's esophagus with a diagnosis of indefinite for dysplasia (IND). The aims of this study were to: (i) determine rates of progression to high grade dysplasia (HGD) or esophageal adenocarcinoma, and compare these with rates for low grade dysplasia (LGD); and (ii) determine the proportion of patients whose histological IND diagnosis changed on follow-up endoscopy. Patients and methods: Demographic, endoscopic, and histologic information of patients with diagnoses of IND and LGD and at least 12 months of follow-up were extracted from the database of a multicenter Barrett's esophagus study. Rates and times for progression to HGD and esophageal adenocarcinoma and regression to nondysplastic epithelium were calculated. Proportions of diagnoses upgraded to HGD/esophageal adenocarcinoma or downgraded to nondysplastic epithelium at first follow-up endoscopy were evaluated. Results: Amongst 2264 patients, 83 with a diagnosis of IND (mean age 60 years, 95% men, 95% white; mean follow-up 5.6 years) and 79 with diagnosis of LGD were identified. In the IND group, annual incidences of esophageal adenocarcinoma and HGD were 0.21% and 0.64%, respectively, representing a combined incidence of 0.8%. Mean time to progression was 4.72 years. Within the IND group 55% patients showed regression to nondysplastic epithelium at first follow-up endoscopy and the overall regression rate was 80%. Corresponding rates in LGD patients were similar. Conclusions: Lesions diagnosed as IND and LGD show similar biological behavior and can be treated as a single category with respect to surveillance and follow-up.

Original languageEnglish (US)
Pages (from-to)669-674
Number of pages6
JournalEndoscopy
Volume47
Issue number8
DOIs
StatePublished - Aug 1 2015

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Barrett Esophagus
Multicenter Studies
Cohort Studies
Adenocarcinoma
Endoscopy
Epithelium
Incidence
Natural History
Demography
Databases

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Sinh, P., Anaparthy, R., Young, P. E., Gaddam, S., Thota, P., Balasubramanian, G., ... Sharma, P. (2015). Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus: A multicenter cohort study. Endoscopy, 47(8), 669-674. https://doi.org/10.1055/s-0034-1391966

Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus : A multicenter cohort study. / Sinh, Preetika; Anaparthy, Rajeswari; Young, Patrick E.; Gaddam, Srinivas; Thota, Prashanthi; Balasubramanian, Gokulakrishnan; Singh, Mandeep; Higbee, April D.; Wani, Sachin; Gupta, Neil; Rastogi, Amit; Mathur, Sharad C.; Bansal, Ajay; Horwhat, John D.; Cash, Brooks D.; Falk, Gary W.; Lieberman, David; Vargo, John J.; Sampliner, Richard E.; Sharma, Prateek.

In: Endoscopy, Vol. 47, No. 8, 01.08.2015, p. 669-674.

Research output: Contribution to journalArticle

Sinh, P, Anaparthy, R, Young, PE, Gaddam, S, Thota, P, Balasubramanian, G, Singh, M, Higbee, AD, Wani, S, Gupta, N, Rastogi, A, Mathur, SC, Bansal, A, Horwhat, JD, Cash, BD, Falk, GW, Lieberman, D, Vargo, JJ, Sampliner, RE & Sharma, P 2015, 'Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus: A multicenter cohort study', Endoscopy, vol. 47, no. 8, pp. 669-674. https://doi.org/10.1055/s-0034-1391966
Sinh, Preetika ; Anaparthy, Rajeswari ; Young, Patrick E. ; Gaddam, Srinivas ; Thota, Prashanthi ; Balasubramanian, Gokulakrishnan ; Singh, Mandeep ; Higbee, April D. ; Wani, Sachin ; Gupta, Neil ; Rastogi, Amit ; Mathur, Sharad C. ; Bansal, Ajay ; Horwhat, John D. ; Cash, Brooks D. ; Falk, Gary W. ; Lieberman, David ; Vargo, John J. ; Sampliner, Richard E. ; Sharma, Prateek. / Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus : A multicenter cohort study. In: Endoscopy. 2015 ; Vol. 47, No. 8. pp. 669-674.
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abstract = "Background and study aim: Data are limited on the natural history of patients with Barrett's esophagus with a diagnosis of indefinite for dysplasia (IND). The aims of this study were to: (i) determine rates of progression to high grade dysplasia (HGD) or esophageal adenocarcinoma, and compare these with rates for low grade dysplasia (LGD); and (ii) determine the proportion of patients whose histological IND diagnosis changed on follow-up endoscopy. Patients and methods: Demographic, endoscopic, and histologic information of patients with diagnoses of IND and LGD and at least 12 months of follow-up were extracted from the database of a multicenter Barrett's esophagus study. Rates and times for progression to HGD and esophageal adenocarcinoma and regression to nondysplastic epithelium were calculated. Proportions of diagnoses upgraded to HGD/esophageal adenocarcinoma or downgraded to nondysplastic epithelium at first follow-up endoscopy were evaluated. Results: Amongst 2264 patients, 83 with a diagnosis of IND (mean age 60 years, 95{\%} men, 95{\%} white; mean follow-up 5.6 years) and 79 with diagnosis of LGD were identified. In the IND group, annual incidences of esophageal adenocarcinoma and HGD were 0.21{\%} and 0.64{\%}, respectively, representing a combined incidence of 0.8{\%}. Mean time to progression was 4.72 years. Within the IND group 55{\%} patients showed regression to nondysplastic epithelium at first follow-up endoscopy and the overall regression rate was 80{\%}. Corresponding rates in LGD patients were similar. Conclusions: Lesions diagnosed as IND and LGD show similar biological behavior and can be treated as a single category with respect to surveillance and follow-up.",
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T1 - Clinical outcomes in patients with a diagnosis of indefinite for dysplasia in Barrett's esophagus

T2 - A multicenter cohort study

AU - Sinh, Preetika

AU - Anaparthy, Rajeswari

AU - Young, Patrick E.

AU - Gaddam, Srinivas

AU - Thota, Prashanthi

AU - Balasubramanian, Gokulakrishnan

AU - Singh, Mandeep

AU - Higbee, April D.

AU - Wani, Sachin

AU - Gupta, Neil

AU - Rastogi, Amit

AU - Mathur, Sharad C.

AU - Bansal, Ajay

AU - Horwhat, John D.

AU - Cash, Brooks D.

AU - Falk, Gary W.

AU - Lieberman, David

AU - Vargo, John J.

AU - Sampliner, Richard E.

AU - Sharma, Prateek

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background and study aim: Data are limited on the natural history of patients with Barrett's esophagus with a diagnosis of indefinite for dysplasia (IND). The aims of this study were to: (i) determine rates of progression to high grade dysplasia (HGD) or esophageal adenocarcinoma, and compare these with rates for low grade dysplasia (LGD); and (ii) determine the proportion of patients whose histological IND diagnosis changed on follow-up endoscopy. Patients and methods: Demographic, endoscopic, and histologic information of patients with diagnoses of IND and LGD and at least 12 months of follow-up were extracted from the database of a multicenter Barrett's esophagus study. Rates and times for progression to HGD and esophageal adenocarcinoma and regression to nondysplastic epithelium were calculated. Proportions of diagnoses upgraded to HGD/esophageal adenocarcinoma or downgraded to nondysplastic epithelium at first follow-up endoscopy were evaluated. Results: Amongst 2264 patients, 83 with a diagnosis of IND (mean age 60 years, 95% men, 95% white; mean follow-up 5.6 years) and 79 with diagnosis of LGD were identified. In the IND group, annual incidences of esophageal adenocarcinoma and HGD were 0.21% and 0.64%, respectively, representing a combined incidence of 0.8%. Mean time to progression was 4.72 years. Within the IND group 55% patients showed regression to nondysplastic epithelium at first follow-up endoscopy and the overall regression rate was 80%. Corresponding rates in LGD patients were similar. Conclusions: Lesions diagnosed as IND and LGD show similar biological behavior and can be treated as a single category with respect to surveillance and follow-up.

AB - Background and study aim: Data are limited on the natural history of patients with Barrett's esophagus with a diagnosis of indefinite for dysplasia (IND). The aims of this study were to: (i) determine rates of progression to high grade dysplasia (HGD) or esophageal adenocarcinoma, and compare these with rates for low grade dysplasia (LGD); and (ii) determine the proportion of patients whose histological IND diagnosis changed on follow-up endoscopy. Patients and methods: Demographic, endoscopic, and histologic information of patients with diagnoses of IND and LGD and at least 12 months of follow-up were extracted from the database of a multicenter Barrett's esophagus study. Rates and times for progression to HGD and esophageal adenocarcinoma and regression to nondysplastic epithelium were calculated. Proportions of diagnoses upgraded to HGD/esophageal adenocarcinoma or downgraded to nondysplastic epithelium at first follow-up endoscopy were evaluated. Results: Amongst 2264 patients, 83 with a diagnosis of IND (mean age 60 years, 95% men, 95% white; mean follow-up 5.6 years) and 79 with diagnosis of LGD were identified. In the IND group, annual incidences of esophageal adenocarcinoma and HGD were 0.21% and 0.64%, respectively, representing a combined incidence of 0.8%. Mean time to progression was 4.72 years. Within the IND group 55% patients showed regression to nondysplastic epithelium at first follow-up endoscopy and the overall regression rate was 80%. Corresponding rates in LGD patients were similar. Conclusions: Lesions diagnosed as IND and LGD show similar biological behavior and can be treated as a single category with respect to surveillance and follow-up.

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