1. Identification of Prognostic Phenotypes of Esophageal Adenocarcinoma in 2 Independent Cohorts
- Author
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Tarek Sawas, Sarah Killcoyne, Prasad G. Iyer, Kenneth K. Wang, Thomas C. Smyrk, John B. Kisiel, Yi Qin, David A. Ahlquist, Anil K. Rustgi, Rui J. Costa, Moritz Gerstung, Rebecca C. Fitzgerald, David A. Katzka, Ayesha Noorani, Paul A.W. Edwards, Nicola Grehan, Barbara Nutzinger, Caitriona Hughes, Elwira Fidziukiewicz, Jan Bornschein, Shona MacRae, Jason Crawte, Gianmarco Contino, Xiaodun Li, Rachel de la Rue, Maria O’Donovan, Ahmad Miremad, Shalini Malhotra, Monika Tripathi, Simon Tavaré, Andy G. Lynch, Matthew Eldridge, Maria Secrier, Lawrence Bower, Ginny Devonshire, Juliane Perner, Sriganesh Jammula, Jim Davies, Charles Crichton, Nick Carroll, Peter Safranek, Andrew Hindmarsh, Vijayendran Sujendran, Stephen J. Hayes, Yeng Ang, Shaun R. Preston, Sarah Oakes, Izhar Bagwan, Vicki Save, Richard J.E. Skipworth, Ted R. Hupp, J. Robert O’Neill, Olga Tucker, Andrew Beggs, Philippe Taniere, Sonia Puig, Timothy J. Underwood, Fergus Noble, Jack Owsley, Hugh Barr, Neil Shepherd, Oliver Old, Jesper Lagergren, James Gossage, Andrew Davies, Fuju Chang, Janine Zylstra, Ula Mahadeva, Vicky Goh, Francesca D. Ciccarelli, Grant Sanders, Richard Berrisford, Catherine Harden, David Bunting, Mike Lewis, Ed Cheong, Bhaskar Kumar, Simon L. Parsons, Irshad Soomro, Philip Kaye, John Saunders, Laurence Lovat, Rehan Haidry, Victor Eneh, Laszlo Igali, Michael Scott, Sharmila Sothi, Sari Suortamo, Suzy Lishman, George B. Hanna, Christopher J. Peters, Anna Grabowska, and Richard Turkington
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Oncology ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Survival ,Adenocarcinoma ,Article ,03 medical and health sciences ,Barrett Esophagus ,0302 clinical medicine ,Esophagus ,Interquartile range ,Internal medicine ,medicine ,Humans ,Stage (cooking) ,Esophageal Adenocarcinoma ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Metaplasia ,Hepatology ,business.industry ,Hazard ratio ,Gastroenterology ,Intestinal metaplasia ,Middle Aged ,medicine.disease ,Prognosis ,United Kingdom ,United States ,Intestines ,medicine.anatomical_structure ,Phenotype ,030220 oncology & carcinogenesis ,Barrett's esophagus ,Cohort ,Etiology ,Regression Analysis ,030211 gastroenterology & hepatology ,business - Abstract
Background & Aims: Most patients with esophageal adenocarcinoma (EAC) present with de novo tumors. Although this could be due to inadequate screening strategies, the precise reason for this observation is not clear. We compared survival of patients with prevalent EAC with and without synchronous Barrett esophagus (BE) with intestinal metaplasia (IM) at the time of EAC diagnosis. Methods: Clinical data were studied using Cox proportional hazards regression to evaluate the effect of synchronous BE-IM on EAC survival independent of age, sex, TNM stage, and tumor location. We analyzed data from a cohort of patients with EAC from the Mayo Clinic (n=411; 203 with BE and IM) and a multicenter cohort from the United Kingdom (n=1417; 638 with BE and IM). Results: In the Mayo cohort, BE with IM had a reduced risk of death compared to patients without BE and IM (hazard ratio [HR] 0.44; 95% CI, 0.34–0.57; PConclusion: Two types of EAC can be characterized based on the presence or absence of BE. These findings could increase our understanding the etiology of EAC, and be used in management and prognosis of patients.
- Published
- 2018
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