TITLE

Does a surgical antireflux procedure decrease the incidence of esophageal adenocarcinoma in Barrett's esophagus? A meta-analysis

AUTHOR(S)
Corey, Kathleen E.; Schmitz, Sarah M.; Shaheen, Nicholas J.
PUB. DATE
November 2003
SOURCE
American Journal of Gastroenterology;Nov2003, Vol. 98 Issue 11, p2390
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
: ObjectiveThe risk of adenocarcinoma of the esophagus is increased among those with Barrett''s esophagus (BE). Whether the risk of cancer in the setting of BE can be decreased by a surgical antireflux procedure (SARP) is unclear. This study compared the reported incidence of esophageal adenocarcinoma in subjects with BE who underwent SARP with those with BE who had medical management.: MethodsWe used MEDLINE to perform a meta-analysis of the English language literature published from 1966 through October 2001. We reviewed abstracts found with the search term “Barrett''s esophagus” and the following: “adenocarcinoma,” “esophageal neoplasm,” “proton pump inhibitor,” “fundoplication,” or “antireflux procedure.” Study entry criteria included 1) trial or cohort study with a report of cancer risk expressible in cancers per patient-year, 2) histologic confirmation of BE and any adenocarcinomas, and 3) adequate description of intervention (medical vs SARP). Data were abstracted by two reviewers using standardized forms. Subgroup comparisons were made using only medical management studies published in the last 5 yr. Multivariable regression controlling for subject age, country of origin, and BE length was performed.: ResultsWe reviewed 1247 abstracts, and 34 met the inclusion criteria. There were a cumulative 4678 patient-years of follow-up in the SARP group and 4906 patient-years in the medical group. The cancer incidence rate in the SARP group was 3.8 cancers/1000 patient-years, compared with 5.3 in the medical group (p = 0.29). Similarly, there was no significant difference between cancer rates when comparing SARP with medical series reported in the last 5 yr (3.8/1000 patient-years vs 4.2/1000 patient-years, p = 0.33). Multivariate analysis controlling for subject age, country of origin, and BE length did not alter these findings.: ConclusionThe reported risk of adenocarcinoma in subjects with BE is low and not significantly decreased by a surgical antireflux procedure. Antireflux surgery in the setting of BE should not be recommended as an antineoplastic measure.
ACCESSION #
11469032

 

Related Articles

  • Barrett's Esophagus on Repeat Endoscopy: Should We Look More Than Once? Rodriguez, Sarah; Mattek, Nora; Lieberman, David; Fennerty, Brian; Eisen, Glenn // American Journal of Gastroenterology;Aug2008, Vol. 103 Issue 8, p1892 

    BACKGROUND: Barrett's esophagus (BE) is the precursor lesion for esophageal adenocarcinoma. The major risk factor for BE is chronic gastroesophageal reflux disease (GERD). Screening patients with longstanding GERD for BE with upper esophagogastroduodenoscopy (EGD) has become the standard...

  • Barrett's esophagus: Prevalence and risk factors in patients with chronic GERD in Upper Egypt. Fouad, Yasser M.; Makhlouf, Madiha M.; Tawfik, Heba M.; El Amin, Hussein; Ghany, Wael Abdel; El-khayat, Hisham R.; Romano, Claudio; Cammarota, Giovanni; Gemelli, Policlinico A.; Gemlli, Largo A. // World Journal of Gastroenterology;7/28/2009, Vol. 15 Issue 28, p3511 

    AIM: To determine the prevalence and possible risk factors of Barrett's esophagus (BE) in patients with chronic gastroesophageal reflux disease (GERD) in El Minya and Assuit, Upper Egypt. METHODS: One thousand consecutive patients with chronic GERD symptoms were included in the study over 2...

  • Sex-specific exposure prevalence of established risk factors for oesophageal adenocarcinoma. Rutegård, M; Nordenstedt, H; Lu, Y; Lagergren, J; Lagergren, P // British Journal of Cancer;8/24/2010, Vol. 103 Issue 5, p735 

    Background:There is an unexplained male predominance in the incidence of oesophageal adenocarcinoma, and the sex-specific distribution of its risk factors in the general population is not known.Methods:A random sample of Swedish citizens aged 40–79 years completed a questionnaire for...

  • Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma. Mayne, Susan T.; Risch, Harvey A.; Dubrow, Robert; Wong-ho Chow; Gammon, Marilie D.; Vaughan, Thomas L.; Borchardt, Lauren; Schoenberg, Janet B.; Stanford, Janet L.; West, A. Brian; Rotterdam, Heidi; Blot, William J.; Fraumeni Jr., Joseph F. // JNCI: Journal of the National Cancer Institute;1/4/2006, Vol. 98 Issue 1, p72 

    Carbonated soft drinks (CSDs) have been associated with gastroesophageal reflux, an established risk factor for esophageal adenocarcinoma. As both CSD consumption and esophageal adenocarcinoma incidence have sharply increased in recent decades, we examined CSD as a risk factor for esophageal and...

  • Esophagopericardial fistula as a rare complication after total gastrectomy for cancer.  // World Journal of Surgical Oncology;2009, Vol. 7, p58 

    Background: Esophagopericardial fistula is a rare but life-threatening complication of benign, malignant or traumatic esophageal disease. It is most commonly associated with benign etiology and carries a high mortality rate which increases with delay in diagnosis. Case presentation: We present a...

  • Barrett's oesophagus and oesophageal adenocarcinoma: time for a new synthesis. Reid, Brian J.; Xiaohong Li; Galipeau, Patricia C.; Vaughan, Thomas L.; Li, Xiaohong // Nature Reviews Cancer;Feb2010, Vol. 10 Issue 2, p87 

    The public health importance of Barrett's oesophagus lies in its association with oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma has risen at an alarming rate over the past four decades in many regions of the Western world, and there are indications that the incidence of...

  • Temozolomide associated with oesophagitis.  // Reactions Weekly;Nov2015, Vol. 1576 Issue 1, p9 

    The article reports on the association of the alkylating agent temozolomide with oesophagitis.

  • Bisphosphonates and esophageal cancer. Elliott, William T. // Critical Care Alert;Oct2010 Pharmacology, p1 

    The article reports on the results of a study, conducted by British Centre for Public Health and the National Institutes of Health (NIH), which revealed the disassociation of oral bisphosphonates and esophageal cancer.

  • Breast implants and offspring health.  // Pediatrics for Parents;1999, Vol. 18 Issue 9, p11 

    Reports on a study conducted by doctors in Denmark, on the risk of esophageal diseases in infants whose mothers had silicone breast implant, published in the November 1998 issue of the `Pediatrics' periodical. Comparison of risk to the infant population as a whole.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics