Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica

Background: The potential progression from intestinal metaplasia to low grade dysplasia, to high grade dysplasia and to adenocarcinoma represents a well recognized sequence in patients with Barrett's esophagus (BE). The time required for this transformation is not well known. Aim: To report the...

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Autores principales:	Burdiles P,Patricio, Csendes J,Attila, Smok,Gladys, Braghetto M,Italo, Korn B,Owen
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2003
Materias:	Barrett esophagus Esophageal diseases Esophageal neoplasms Esophagectomy
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000600001
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spelling	oai:scielo:S0034-988720030006000012004-12-13Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópicaBurdiles P,PatricioCsendes J,AttilaSmok,GladysBraghetto M,ItaloKorn B,Owen Barrett esophagus Esophageal diseases Esophageal neoplasms Esophagectomy Background: The potential progression from intestinal metaplasia to low grade dysplasia, to high grade dysplasia and to adenocarcinoma represents a well recognized sequence in patients with Barrett's esophagus (BE). The time required for this transformation is not well known. Aim: To report the results of a 10 years follow up of patients with BE. Material and methods: Between 1989 and 2000 we followed 402 patients with BE. Results: Sixty six subjects (16.2%) presented low grade dysplasia at the time of diagnosis and 10 patients (2 women/8 men) developed adenocarcinoma during the follow-up period. Four out of these 10 patients were operated because of gastro-esophageal reflux disease, but after 3-5 years, reflux symptoms recurred. The other 6 patients rejected surgery and were on Omeprazole with good symptomatic results. Two patients had a short BE (<3 cm), seven cases had a classic BE (3-10 cm) and one patient had an extensive >10 cm BE. The mean time elapsed from intestinal metaplasia to low grade dysplasia was 9 months, to high grade dysplasia 56 months and to adenocarcinoma 82 months. From low grade dysplasia to early cancer it was 18 months, from high grade dysplasia to early cancer 14 months and from high grade dysplasia to advanced transmural cancer 14 months. All patients were subjected to esophagectomy. Five patients detected at State I are alive without any evidence of recurrence after 36 to 130 months after surgery. Five patients with advanced transmural carcinoma subjected to radical esophagectomy died because of progression of the malignancy between 3 and 24 months after surgery. Conclusions: Progression to adenocarcinoma may occur even in absence of reflux symptoms while on acid suppression therapy. Detection at early stage intestinal metaplasia in the esophagus offers a high chance of cure after surgical resection (Rev Méd Chile 2003; 131: 587-96)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.131 n.6 20032003-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000600001es10.4067/S0034-98872003000600001
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Barrett esophagus Esophageal diseases Esophageal neoplasms Esophagectomy
spellingShingle	Barrett esophagus Esophageal diseases Esophageal neoplasms Esophagectomy Burdiles P,Patricio Csendes J,Attila Smok,Gladys Braghetto M,Italo Korn B,Owen Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
description	Background: The potential progression from intestinal metaplasia to low grade dysplasia, to high grade dysplasia and to adenocarcinoma represents a well recognized sequence in patients with Barrett's esophagus (BE). The time required for this transformation is not well known. Aim: To report the results of a 10 years follow up of patients with BE. Material and methods: Between 1989 and 2000 we followed 402 patients with BE. Results: Sixty six subjects (16.2%) presented low grade dysplasia at the time of diagnosis and 10 patients (2 women/8 men) developed adenocarcinoma during the follow-up period. Four out of these 10 patients were operated because of gastro-esophageal reflux disease, but after 3-5 years, reflux symptoms recurred. The other 6 patients rejected surgery and were on Omeprazole with good symptomatic results. Two patients had a short BE (<3 cm), seven cases had a classic BE (3-10 cm) and one patient had an extensive >10 cm BE. The mean time elapsed from intestinal metaplasia to low grade dysplasia was 9 months, to high grade dysplasia 56 months and to adenocarcinoma 82 months. From low grade dysplasia to early cancer it was 18 months, from high grade dysplasia to early cancer 14 months and from high grade dysplasia to advanced transmural cancer 14 months. All patients were subjected to esophagectomy. Five patients detected at State I are alive without any evidence of recurrence after 36 to 130 months after surgery. Five patients with advanced transmural carcinoma subjected to radical esophagectomy died because of progression of the malignancy between 3 and 24 months after surgery. Conclusions: Progression to adenocarcinoma may occur even in absence of reflux symptoms while on acid suppression therapy. Detection at early stage intestinal metaplasia in the esophagus offers a high chance of cure after surgical resection (Rev Méd Chile 2003; 131: 587-96)
author	Burdiles P,Patricio Csendes J,Attila Smok,Gladys Braghetto M,Italo Korn B,Owen
author_facet	Burdiles P,Patricio Csendes J,Attila Smok,Gladys Braghetto M,Italo Korn B,Owen
author_sort	Burdiles P,Patricio
title	Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
title_short	Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
title_full	Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
title_fullStr	Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
title_full_unstemmed	Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica
title_sort	progresión de metaplasia intestinal a adenocarcinoma en esófago de barrett: utilidad de la vigilancia endoscópica
publisher	Sociedad Médica de Santiago
publishDate	2003
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000600001
work_keys_str_mv	AT burdilesppatricio progresiondemetaplasiaintestinalaadenocarcinomaenesofagodebarrettutilidaddelavigilanciaendoscopica AT csendesjattila progresiondemetaplasiaintestinalaadenocarcinomaenesofagodebarrettutilidaddelavigilanciaendoscopica AT smokgladys progresiondemetaplasiaintestinalaadenocarcinomaenesofagodebarrettutilidaddelavigilanciaendoscopica AT braghettomitalo progresiondemetaplasiaintestinalaadenocarcinomaenesofagodebarrettutilidaddelavigilanciaendoscopica AT kornbowen progresiondemetaplasiaintestinalaadenocarcinomaenesofagodebarrettutilidaddelavigilanciaendoscopica
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Progresión de metaplasia intestinal a adenocarcinoma en esófago de Barrett: utilidad de la vigilancia endoscópica

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