Original articleClinical endoscopyIncidence of esophageal adenocarcinoma in Barrett's esophagus with low-grade dysplasia: a systematic review and meta-analysis
Section snippets
Search strategy
We conducted a systematic literature search of MEDLINE (1966 to December 31, 2012) and EMBASE (1988 to December 31, 2012) for all relevant articles on the risk of EAC in patients with BE. Key words used in the search included a combination of “Barrett's esophagus,” “Barrett's neoplasia,” “Barrett's epithelium,” or “intestinal metaplasia” and “esophageal cancer,” “esophageal adenocarcinoma,” or “esophageal neoplasia.” The search was restricted to the studies in human participants published in
Results
From a total of 3703 citations identified by using our search strategy, 51 studies reported EAC incidence among patients with BE-LGD. Of these, 17 studies were excluded because they did not meet the study criteria (2 studies had follow-up <2 years;21, 22 2 studies lacked precise details regarding follow-up;23, 24 there were 13 studies with redundant study populations25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37); an additional 10 studies on patients who had undergone anti-reflux surgery
Discussion
Current management strategies for BE-LGD are unclear, and endoscopic eradication therapy is not routinely recommended.1 This is because of relative paucity of data on the natural history of BE-LGD with regard to progression to EAC and/or HGD. Additionally, there are limited data on cause-specific mortality in patients with BE-LGD from which to project cost-effectiveness of surveillance and endoscopic eradication therapy in this cohort of patients. In this systematic review and meta-analysis of
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2023, Gastroenterologia y HepatologiaCitation Excerpt :In patients with NDBE, LGD and HGD, the risk of neoplastic progression is around 0.2–0.5%, 0.7% and 7% per year respectively.22,23 A meta-analysis based on 47 studies showed that the incidence of EAC in BE was 6.1 per 1000 person-years24; in patients with HGD the incidence is estimated in 6 per 100 patient-years25 and 0.54% per year for LGD.26 The incidence of EAC in patients with BE increases progressively with age specially in patients over 70 years of age.27,28
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 983.
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Drs Singh and Manickam contributed equally to the article.