Location, location, location: does early cancer in Barrett's esophagus have a preference?
Por:
Enestvedt, BK, Lugo, R, Guarner-Argente, C, Shah, P, Falk, GW, Furth, E, Ginsberg, GG
Publicada:
1 sep 2013
Resumen:
Background: Early cancer (high-grade dysplasia [HGD] and intramucosal carcinoma [ImCa]) associated with Barrett's esophagus (BE) may have a circumferential spatial predilection.
Objective: To describe the esophageal circumferential location of early cancer in BE.
Design and Setting: Retrospective study, single tertiary referral center.
Patients and Intervention: One hundred nineteen patients were referred for endoscopic eradication therapy for early cancer associated with BE. Endoscopic images and reports and pathology were reviewed.
Main Outcome Measurements: Circumferential location designation of early cancer in BE by using a clock-face orientation.
Results: One hundred nineteen of 131 patients referred for endoscopic eradication therapy had a location designation for their advanced histology (91.9%). There were a total of 57 patients (47.9%) with HGD and 62 patients (52.1%) with ImCa. There was a significantly higher rate of early cancer (HGD or ImCa) in the right hemisphere (12 to 6 o'clock location) compared with the left hemisphere (84.9% vs 15.1%, P < .0001). The highest percentage of early cancer was found in the 12 to 3 o'clock quadrant (64.7%); 71.9% of HGD and 58.1% of ImCa lesions were located in the 12 to 3 o'clock quadrant.
Limitations: Retrospective design, single center.
Conclusions: Early cancer associated with BE is far more commonly found in the right hemisphere of the esophagus (12 to 6 o'clock) with the highest rate in the 12 to 3 o'clock quadrant. These findings support enhanced scrutiny of the right hemisphere of the esophagus during surveillance and endoscopic treatment of patients with BE.
Filiaciones:
Enestvedt, BK:
Temple Univ, Div Gastroenterol, Dept Med, Sch Med, Philadelphia, PA 19104 USA
Lugo, R:
Univ Penn, Dept Med, Div Gastroenterol, Perelman Sch Med, Philadelphia, PA 19104 USA
Guarner-Argente, C:
Univ Autonoma Barcelona, Dept Gastroenterol, Hosp Santa Cruz & St Pau, E-08193 Barcelona, Spain
Shah, P:
Mem Sloan Kettering Canc Ctr, Dept Med, Div Gastroenterol & Nutr Serv, New York, NY 10021 USA
Falk, GW:
Temple Univ, Div Gastroenterol, Dept Med, Sch Med, Philadelphia, PA 19104 USA
Furth, E:
Univ Penn, Dept Pathol, Perelman Sch Med, Philadelphia, PA 19104 USA
Ginsberg, GG:
Temple Univ, Div Gastroenterol, Dept Med, Sch Med, Philadelphia, PA 19104 USA
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