SynthesisThe American journal of gastroenterology2012
The risk of lymph-node metastases in patients with high-grade dysplasia or intramucosal carcinoma in Barrett's esophagus: a systematic review.
Synthesis in The American journal of gastroenterology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 2 of them syntheses that pooled it.
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Who cites it
75 citing papers in PubMed, 2 syntheses or guidelines pooled it, 241 citations in OpenAlex.
- AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett's Esophagus and Related Neoplasia.Gastroenterology · 2024Guideline
- Pooled it
- Trial
- Detection of high-grade dysplasia and adenocarcinoma in Barrett's esophagus using high-resolution virtual chromoendoscopy versus the Seattle protocol: the CONVERSE study.BMC gastroenterology · 2026Article
- Impact of primary endoscopic resection on oncological outcomes after esophagectomy for cancer: a retrospective propensity score-based cohort study.Surgical endoscopy · 2024Article
- Optimizing management for early-stage esophageal adenocarcinoma: longitudinal results from a multidisciplinary program.Surgical endoscopy · 2023Article
- Endoscopic Management of Dysplastic Barrett's Oesophagus and Early Oesophageal Adenocarcinoma.Cancers · 2023Review
- Feasibility and Safety of Tailored Lymphadenectomy Using Sentinel Node-Navigated Surgery in Patients with High-Risk T1 Esophageal Adenocarcinoma.Annals of surgical oncology · 2023Article
- What Is "Cold" and What Is "Hot" in Mucosal Ablation for Barrett's Oesophagus-Related Dysplasia: A Practical Guide.Life (Basel, Switzerland) · 2023Review
- Diagnosis and Management of Barrett's Esophagus.Journal of clinical medicine · 2023Review
- Usefulness of the Japan Esophageal Society Classification of Barrett's Esophagus for Diagnosing the Lateral Extent of Superficial Short-Segment Barrett's Esophageal Cancer.Gastrointestinal tumors · 2022Article
- Management of Dysplastic Barrett's Esophagus and Early Esophageal Adenocarcinoma.Gastroenterology clinics of North America · 2022Review
- Endoscopic Management of Barrett's Esophagus.Digestive diseases and sciences · 2022Review
- Feasibility of sentinel node navigated surgery in high-risk T1b esophageal adenocarcinoma patients using a hybrid tracer of technetium-99 m and indocyanine green.Surgical endoscopy · 2022Article
- Barrett's esophagus: Review of natural history and comparative efficacy of endoscopic and surgical therapies.World journal of gastrointestinal oncology · 2022Review
- Endoscopic resection with adjuvant treatment versus esophagectomy for early-stage esophageal cancer.Surgical endoscopy · 2022Article
- [Treatment recommendations for early esophageal cancer : Endoscopic and surgical options].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
- Lymph node metastasis pattern and significance of left gastric artery lymph node dissection in esophagectomy for esophageal cancers.World journal of surgical oncology · 2021Article
- Towards screening Barrett's oesophagus: current guidelines, imaging modalities and future developments.Clinical journal of gastroenterology · 2020Review
- Outcomes of patients with submucosal (T1b) esophageal adenocarcinoma: a multicenter cohort study.Gastrointestinal endoscopy · 2020Article
15 more citing papers are in PubMed but not listed here.
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesEndoscopic eradication therapy is used to treat mucosal neoplasms in Barrett's esophagus, but cannot cure cancers that have metastasized to lymph nodes. The risk of such metastases has been proposed as a reason to consider esophagectomy rather than endoscopic therapy for esophageal mucosal neoplasia. The objective of our study was to determine the frequency of lymph-node metastases in patients with high-grade dysplasia (HGD) and intramucosal carcinoma in Barrett's esophagus.
methodsWe performed a systematic review using the PRISMA guidelines to identify studies that included patients who had esophagectomy for HGD or intramucosal carcinoma in Barrett's esophagus, and that reported final pathology results after examination of esophagectomy specimens.
resultsWe identified 70 relevant reports that included 1,874 patients who had esophagectomy performed for HGD or intramucosal carcinoma in Barrett's esophagus. Lymph-node metastases were found in 26 patients (1.39 % , 95 % CI 0.86 – 1.92). No metastases were found in the 524 patients who had a final pathology diagnosis of HGD, whereas 26 (1.93 % , 95 % CI 1.19 – 2.66 %) of the 1,350 patients with a final pathology diagnosis of intramucosal carcinoma had positive lymph nodes.
conclusionsThe risk of unexpected lymph-node metastases for patients with mucosal neoplasms in Barrett's esophagus is in the range of 1 – 2 %. Esophagectomy has a mortality rate that often exceeds 2 %, with substantial morbidity and no guarantee of curing metastatic disease. Therefore, the risk of lymph node metastases alone does not warrant the choice of esophagectomy over endoscopic therapy for HGD and intramucosal carcinoma in Barrett's esophagus.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.