[Progression from intestinal metaplasia to XXXX in Barrett s esophagus: usefulness of endoscopic surveillance].

@entity1 @entity355 @entity304 @entity5 @entity189 @entity354 @entity258 @entity420 @entity4546 @entity1141
BACKGROUND: The potential progression from intestinal metaplasia to @entity258 , to high grade @entity1141 and to @entity420 represents a well recognized sequence in @entity1 with @entity355 ( @entity355 ). The time required for this transformation is not well known. AIM: To report the results of a 10 years follow up of @entity1 with @entity355 . MATERIAL AND METHODS: Between 1989 and 2000 we followed 402 @entity1 with @entity355 . RESULTS: Sixty six subjects (16.2%) presented @entity258 at the time of diagnosis and 10 @entity1 (2 @entity1 /8 @entity1 ) developed @entity420 during the follow-up period. Four out of these 10 @entity1 were operated because of @entity354 , but after 3-5 years, @entity304 recurred. The other 6 @entity1 rejected surgery and were on @entity4546 with good symptomatic results. Two @entity1 had a short @entity355 (< 3 cm), seven cases had a classic @entity355 (3-10 cm) and one @entity1 had an extensive > 10 cm @entity355 . The mean time elapsed from intestinal metaplasia to @entity258 was 9 months, to high grade @entity1141 56 months and to @entity420 82 months. From @entity258 to early @entity5 it was 18 months, from high grade @entity1141 to early @entity5 14 months and from high grade @entity1141 to advanced transmural @entity5 14 months. All @entity1 were subjected to esophagectomy. Five @entity1 detected as State I are alive without any evidence of recurrence after 36 to 130 months after surgery. Five @entity1 with advanced transmural @entity189 subjected to radical esophagectomy died because of progression of the malignancy between 3 and 24 months after surgery. CONCLUSIONS: Progression to @entity420 may occur even in absence of @entity304 while on acid suppression therapy. Detection at early stage intestinal metaplasia in the esophagus offers a high chance of cure after surgical resection.
