ArticleUnited European gastroenterology journal2025
Cancer Burden on Piecemeal Endoscopic Resection of Early Adenocarcinoma in Barrett's Oesophagus Correlates With the Risk of Neoplastic Recurrence.
Article in United European gastroenterology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A prospective cohort study evaluating disease-specific mortality in patients with early-stage Barrett's esophagus-related neoplasia following endoscopic therapy.Surgical endoscopy · 2026Article
- Cancer Burden on Piecemeal Endoscopic Resection of Early Adenocarcinoma in Barrett's Oesophagus Correlates With the Risk of Neoplastic Recurrence.United European gastroenterology journal · 2025Article
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11 authors.
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Abstract
BACKGROUND AND STUDY
aimsEndoscopic resection (ER) is curative for early-stage oesophageal adenocarcinoma (OAC) without high-risk features. Piecemeal endoscopic mucosal resection (pEMR) prevents assessment of lateral margins, complicating risk estimation for neoplastic recurrence. We investigated the risk factors for residual and recurrent OAC post-pEMR.
methodsWe performed a longitudinal study of two independent patient cohorts: the test cohort who underwent piecemeal or en-bloc ER (n = 140) and the validation cohort who underwent pEMR only (n = 89). Inclusion criteria were: OAC stage T1a or low-risk T1b, no lympho-vascular invasion, and R0 resection. The primary outcome was residual OAC at first post-ER endoscopy, and secondary outcomes were residual neoplasia (high-grade dysplasia and/or OAC), recurrence of neoplasia at any post-ER endoscopy, and remission of neoplasia, dysplasia and metaplasia at most recent endoscopy.
resultsIn the test cohort, the incidence of neoplastic recurrence was higher in patients treated with pEMR (n = 54, 49%) versus en-bloc ER (n = 7, 23%) (p = 0.021). The percentage of pEMR specimens with OAC was an independent risk factor for residual OAC at the first post-pEMR endoscopy (OR for a 10% increase = 1.24, CI = 1.03-1.51, p = 0.025). A 50% cut-off of pEMR specimens with OAC was optimal to predict residual OAC (specificity = 0.68, sensitivity = 0.63). Rates of residual (p = 0.039) and recurrent (p = 0.0052) OAC were higher when > 50% of pEMR specimens were involved by OAC. In the validation cohort, recurrent OAC was also more frequent when cancer burden was > 50% (p = 0.013).
conclusionsHigh cancer burden on pEMR specimens correlates with the risk of residual OAC. Post-pEMR site check before endoscopic ablation is recommended if more than 50% of pEMR specimens show OAC.
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