Clinical and Histological Determinants of Mortality for Patients with Barrett's Esophagus-related T1 Esophageal Adenocarcinoma.

[esophageal adenocarcinoma]

Superficial (T 1 ) esophageal adenocarcinoma (EAC ) is commonly treated by endoscopic resection , yet little is known about factors that predict outcomes of this approach . We assessed clinical and histologic variables associated with overall survival times of patients with T 1 EAC who received therapy .In a retrospective analysis , we collected data from patients who underwent endoscopic mucosal resection (EMR ) for T 1 EAC (194 with T 1 a and 75 with T 1 b ) at the Mayo Clinic , from 1995 through 2011 . EMR specimens were systematically reviewed for depth of invasion , presence of lymphovascular invasion , grade of differentiation , and status of resection margins . Kaplan-Meier curves and proportional hazards regression models were used in statistical analyses .Demographic characteristics were similar between patients with T 1 a and T 1 b EAC . Overall survival at 5 years following EMR was 74 .4 % for patients with T 1 a (95 % confidence interval [CI ], 67 .6 %-81 .8 %) and 53 .2 % for patients with T 1 b EAC (95 % CI 40 .3 %-70 .1 %). Of surviving patients with T 1 a EAC , 94 .1 % remained free of cancer (95 % CI , 89 .8 %-98 .5 %), and 94 .7 % of surviving patients with T 1 b EAC remained free of cancer (95 % CI , 85 .2 %-100 %). A multivariable model associated older age (per 10 -year increment ), evidence of lymphovascular invasion , and deep margin involvement with reduced overall survival in patients with T 1 EAC CONCLUSION : Systematic assessment of EMR specimens can help predict mortality and potentially guide treatment options for patients with T 1 EAC .

Diseases
Validation

Diseases presenting "reduced overall survival in patients with t1" symptom

esophageal adenocarcinoma

You can validate or delete this automatically detected symptom