The small proportion of patients with esophageal adenocarcinoma previously diagnosed with Barrett’s esophagus exhibited improved survival compared with those without a previous diagnosis in a recent study.
Researchers in Northern Ireland conducted a retrospective population-based study of 716 patients (mean age at cancer diagnosis, 69.7 years; 73.3% men) diagnosed with esophageal adenocarcinoma (EAC) from 2003 to 2008. Based on data from the Northern Ireland BE registry, 52 patients (7.3%) also were diagnosed with Barrett’s esophagus (BE) at least 6 months before EAC confirmation.
In tumor analysis for stages 1 or 2, EAC patients who had been diagnosed with previous BE showed lower disease stage (44.2% vs. 11.1%; P<.001) than those without BE diagnoses. They also had a greater rate of surgical resection (50% vs. 25.5%; P<.001) among the 195 resected patients, and a greater proportion of low- and intermediate-grade tumors (46.2% vs. 26.5%; P=.011) compared with EAC patients without a prior BE diagnosis.
Among the 610 deaths recorded, 28 occurred in patients with a previous BE diagnosis (HR=0.39; 95% CI, 0.27-0.58), which was slightly affected when adjusted for age, sex and tumor grade (aHR=0.44; 95% CI, 0.3-0.64). When researchers factored in lead time bias, survival was attenuated (HR=0.65; 95% CI, 0.45-0.95) but remained in EAC patients diagnosed with BE.
“Although the true benefits or harms of BE diagnosis and surveillance cannot be conclusively determined by observational studies, our results indicate that prior identification of BE results in an improvement in survival in those patients who develop EAC,” the researchers concluded. “Better methods of identifying patients in the population at greatest risk of developing esophageal adenocarcinoma are required in order to allow targeted surveillance and improve population outcomes from esophageal adenocarcinoma.”
Disclosure: Researcher Shivaram K. Bhat, PhD, MB, Bch, reports receiving fellowship support from the Research and Development office, Northern Ireland, during the study.