A prospective outcomes study in patients with and esophageal cancer (EAC) and Barrett's esophagus (BE) associated neoplasia being evaluated for endoscopic eradication therapy (EET).
Patients will be enrolled in this study at the participating centers when evaluated in gastro-intestinal (GI) clinics and endoscopy suites. Initial evaluation of patients will include collection of data on demographics, assessment of risk factors such as smoking, metabolic syndrome, family history and detailed medication history, and past surgical history. All patients will be complete questionnaires regarding Gastroesophageal Reflux Disease (GERD) symptoms, GERD related quality of life (QOL) and overall health related QOL. Details of all previous endoscopic and surgical evaluation along with histopathology data will be documented. Patients undergoing endoscopic evaluation at the participating centers will have their endoscopic and histopathology results documented. This will include data collection regarding use of advanced imaging techniques, details regarding tissue acquisition, EET and adverse events. Patients undergoing esophagectomy will have surgical details documented along with complications related to surgery. Similarly, details regarding chemoradiation treatments will be documented .
Study Type
OBSERVATIONAL
Enrollment
5,000
Endoscopic eradication therapies (EET) includes endoscopic mucosal resection (EMR), which describes the process by which the area most likely to harbor highest grade of dysplasia/neoplasia is removed; radiofrequency ablation (RFA), which describes the process by which Barrett's segments are removed via burning/ablation; and cryotherapy.
The esophagus is surgically removed
Chemical substances are used to treat cancer
UCLA Medical Center
Los Angeles, California, United States
RECRUITINGMoffitt Cancer Center
Tampa, Florida, United States
RECRUITINGNorthwestern Memorial Hospital
Chicago, Illinois, United States
RECRUITINGOverall improvement of patient outcomes in patients treated with endoscopic eradication therapy (EET).
A systematic, prospective collection of data from a large cohort of patients with BE and EAC undergoing EET will provide useful data in effort to improve overall patient outcomes.
Time frame: 5 years
Long-term effectiveness or durability of EET in BE related neoplasia.
To report on long-term effectiveness or durability of EET in BE related neoplasia.
Time frame: 5 years
Quality of life (QOL) in patients undergoing endoscopic eradication therapies for Barrett's associated neoplasia
To assess quality of life (QOL) using the Promise GERD HRQL (Health Related Quality of Life) questionnaire in patients undergoing endoscopic eradication therapies for Barrett's associated neoplasia
Time frame: 5 years
Recurrence rate of neoplasia
To report on the recurrence rate of neoplasia (defined as number of patients with established eradicated neoplasia post-EET who are found to have recurrent intestinal metaplasia on subsequent surveillance biopsies)
Time frame: 5 years
Recurrence rate of intestinal metaplasia
To report on the recurrence rate intestinal metaplasia (defined as number of patients with established eradicated intestinal metaplasia and/or neoplasia post-EET who are found to have recurrent intestinal metaplasia on subsequent surveillance biopsies).
Time frame: 5 years
Recurrence rate based on baseline dysplasia, Barrett's length, and treatment modality
Percentage of patients of different baseline Barrett's treatment modalities (EMR vs. RFA vs. cryotherapy) whose Barrett's is persistent despite treatment and/or recurs post-eradication. Percentage of patients of different baseline Barrett's lengths whose Barrett's is persistent despite treatment and/or recurs post-eradication. Percentage of patients of different baseline Barrett's histologies (i.e. high grade dysplasia/intramucosal cancer vs. low grade dysplasia) whose Barrett's is persistent despite treatment and/or recurs post-eradication.
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Cancer cells are destroyed by radiation therapy.
Washington University
St Louis, Missouri, United States
RECRUITINGTime frame: 5 years
Persistence rate based on baseline dysplasia, Barrett's length, and treatment modality
Percentage of patients of different baseline Barrett's treatment modalities (EMR vs. RFA vs. cryotherapy) whose Barrett's is persistent despite treatment and/or recurs post-eradication. Percentage of patients of different baseline Barrett's lengths whose Barrett's is persistent despite treatment and/or recurs post-eradication. Percentage of patients of different baseline Barrett's histologies (i.e. high grade dysplasia/intramucosal cancer vs. low grade dysplasia) whose Barrett's is persistent despite treatment and/or recurs post-eradication.
Time frame: 5 years
Adverse event rates associated with EET for BE associated neoplasia and EAC.
To determine adverse event rates associated with EET for BE associated neoplasia and EAC.
Time frame: 5 years
Determine health-care utilization including endoscopic surveillance practices and outcomes in BE patients with and without neoplasia
Number of BE patients (both with and without neoplasia) in the general population who receive various endoscopic interventions (including RFA, cryotherapy, EMR, endoscopic surveillance)
Time frame: 5 years
Magnitude of risk factors for BE.
The number of BE patients who fall into specific age cohorts; the number of BE patients who are male/female; the number of BE patients who fall into specific BMI cohorts; the number of BE patients who have used tobacco and/or currently use tobacco; the number of BE patients who have GERD symptoms; the number of BE patients who have metabolic syndrome; the number of BE patients who take aspirin, NSAIDS, anti-hyperglycemic medications, and/or statins.
Time frame: 5 years
Magnitude of risk factors for BE related neoplasia.
The number of BE related neoplasia patients who fall into specific age cohorts; the number of BE related neoplasia patients who are male/female; the number of BE related neoplasia patients who fall into specific BMI cohorts; the number of BE related neoplasia patients who have used tobacco and/or currently use tobacco; the number of BE related neoplasia patients who have GERD symptoms; the number of BE related neoplasia patients who have metabolic syndrome; the number of BE related neoplasia patients who take aspirin, NSAIDS, anti-hyperglycemic medications, and/or statins.
Time frame: 5 years
Magnitude of risk factors for EAC.
The number of EAC patients who fall into specific age cohorts; the number of EAC patients who are male/female; the number of EAC patients who fall into specific BMI cohorts; the number of EAC patients who have used tobacco and/or currently use tobacco; the number of EAC patients who have GERD symptoms; the number of EAC patients who have metabolic syndrome; the number of EAC patients who take aspirin, NSAIDS, anti-hyperglycemic medications, and/or statins.
Time frame: 5 years
Impact of endoscopic and radiologic imaging modalities.
Number of patients whose treatment plan changes due to endoscopic ultrasound and/or Computed Tomography-Positron Emission Tomography (CT-PET) findings
Time frame: 5 years
Median time to recurrence of intestinal metaplasia
To report on the median time to recurrence (measured median amount of months between complete eradication and recurrence of intestinal metaplasia).
Time frame: 5 years
Median time to recurrence of neoplasia
To report on the median time to recurrence (measured median amount of months between complete eradication and recurrence of neoplasia).
Time frame: 5 years