title: Surveillance of patients with long-segment Barrett's esophagus: A multicenter prospective cohort study in Japan.
abstract: OBJECTIVE
  The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively.
  
  
  METHODS
  This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed.
  
  
  RESULTS
  Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection.
  
  
  CONCLUSIONS
  The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Sakai
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ohata
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.affiliation: Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.affiliation: Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Iijima
authors.affiliation: Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.affiliation: Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Sakura Gastroenterology and Digestive Surgery, Susono, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Inayoshi
authors.affiliation: Department of Endoscopy, Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Amano
authors.affiliation: Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Furuta
authors.affiliation: Department of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.affiliation: Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
keywords: Barrett's esophagus (BE); esophageal adenocarcinoma (EAC); prospective cohort study