Endoscopy 2023; 55(S 02): S203-S204
DOI: 10.1055/s-0043-1765534
Abstracts | ESGE Days 2023
ePoster

Limited risk of residual cancer after endoscopic resection of early Barrett’s neoplasia with confirmed vertical R1 margin: a nationwide cohort in the Netherlands

L. van Tilburg
1   Erasmus University Medical Center, Rotterdam, Netherlands
,
E.P. D. Verheij
2   Amsterdam UMC, locatie AMC, Amsterdam, Netherlands
,
S.E. M. Van De Ven
1   Erasmus University Medical Center, Rotterdam, Netherlands
,
S. N. Van Munster
2   Amsterdam UMC, locatie AMC, Amsterdam, Netherlands
,
B.L.A. M. Weusten
3   St. Antonius Hospital, Nieuwegein, Netherlands
4   UMC Utrecht, Utrecht, Netherlands
,
L. Alvarez Herrero
3   St. Antonius Hospital, Nieuwegein, Netherlands
,
L.A. A. Brosens
4   UMC Utrecht, Utrecht, Netherlands
,
G. M. Raicu
3   St. Antonius Hospital, Nieuwegein, Netherlands
,
W. B. Nagengast
5   University Medical Center Groningen, Groningen, Netherlands
,
J. Westerhof
5   University Medical Center Groningen, Groningen, Netherlands
,
G. Kats-Ugurlu
5   University Medical Center Groningen, Groningen, Netherlands
,
E. J. Schoon
6   Catharina Ziekenhuis, Eindhoven, Netherlands
,
W. L. Curvers
6   Catharina Ziekenhuis, Eindhoven, Netherlands
,
I. G. Van Lijnschoten
7   Eurofins PAMM – Laboratorium voor pathologie en medische microbiologie, Veldhoven, Netherlands
,
A. Alkhalaf
8   Isala Zwolle, Zwolle, Netherlands
,
F.C. P. Moll
8   Isala Zwolle, Zwolle, Netherlands
,
P.J. F. De Jonge
1   Erasmus University Medical Center, Rotterdam, Netherlands
,
M.H.M. G. Houben
9   Haga Ziekenhuis, Den Haag, Netherlands
,
J. S. Van Der Laan
9   Haga Ziekenhuis, Den Haag, Netherlands
,
T. J. Tang
10   IJsselland Hospital, Capelle aan den IJssel, Netherlands
,
A.H.A. G. Ooms
11   Pathan B.V., Rotterdam, Netherlands
,
J.J.G.H. M. Bergman
2   Amsterdam UMC, locatie AMC, Amsterdam, Netherlands
,
R. E. Pouw
2   Amsterdam UMC, locatie AMC, Amsterdam, Netherlands
,
L. Oudijk
1   Erasmus University Medical Center, Rotterdam, Netherlands
,
M. Doukas
1   Erasmus University Medical Center, Rotterdam, Netherlands
,
S. L. Meijer
2   Amsterdam UMC, locatie AMC, Amsterdam, Netherlands
,
M. Jansen
12   University College London, London, United Kingdom
,
A. D. Koch
1   Erasmus University Medical Center, Rotterdam, Netherlands
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    Aims To assess the risk of local residual cancer in patients treated with endoscopic resection (ER) for Barrett’s neoplasia with a histologically confirmed tumor-positive vertical margin (R1v).

    Methods We included patients treated with ER for Barrett's neoplasia since 2008 in the Dutch Barrett Expert Centers, with documented with R1v. Digital pathology slides of resection specimens were re-assessed by 4 expert pathologists until consensus was reached regarding the vertical margin. The primary outcome was the presence of residual cancer.

    Results 110 patients were included, which were treated with EMR (n=74) and ESD (n=36) for T1a (n=19) and T1b (n=91) cancer. 108 (98%) ER specimens with documented R1v were re-assessed, confirming R1v in 78 patients (72%) and revealing Rx/R0 in 30 patients (28%). Seven patients with confirmed R1v had no follow-up. Among remaining confirmed R1v (n=71), residual cancer was present in 29 (41%) patients, detected in the surgical specimen (n=10), during endoscopic scar assessment (n=13), or both (n=8) ([Fig. 1]). Endoscopic scar assessment detected all residual cancers in patients treated with additional surgery (n=6). The risk of residual cancer was higher but not significantly increased with increasing tumor width in the vertical margin (OR 1.44, 95% CI 0.95-2.18 for every increase of 1000µm).

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    Fig. 1

    Conclusions No residual cancer was present in 59% of the patients with confirmed vertical R1 margin after endoscopic resection of early Barrett's neoplasia. The pathological assessment of vertical R1 margins appears challenging, as only 72% of documented vertical R1 cases were confirmed during re-assessment. The tumor width in the vertical margin might be useful to identify patients at highest risk of residual cancer after ER with R1v.


     

    Conflicts of interest

    Authors do not have any conflict of interest to disclose.

    Publikationsverlauf

    Artikel online veröffentlicht:
    14. April 2023

    © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved.

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    Fig. 1