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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
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
