Consensus Statements for Management of Barrett's Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process

Cathy Bennett; Nimish Vakil; Jacques Bergman; Rebecca Harrison; Robert Odze; Michael Vieth; Scott Sanders; Laura Gay; Oliver Pech; Gaius Longcroft–Wheaton; Yvonne Romero; John Inadomi; Jan Tack; Douglas A. Corley; Hendrik Manner; Susi Green; David Al Dulaimi; Haythem Ali; Bill Allum; Mark Anderson; Howard Curtis; Gary Falk; M. Brian Fennerty; Grant Fullarton; Kausilia Krishnadath; Stephen J. Meltzer; David Armstrong; Robert Ganz; Gianpaolo Cengia; James J. Going; John Goldblum; Charles Gordon; Heike Grabsch; Chris Haigh; Michio Hongo; David Johnston; Ricky Forbes–Young; Elaine Kay; Philip Kaye; Toni Lerut; Laurence B. Lovat; Lars Lundell; Philip Mairs; Tadakuza Shimoda; Stuart Spechler; Stephen Sontag; Peter Malfertheiner; Iain Murray; Manoj Nanji; David Poller; Krish Ragunath; Jaroslaw Regula; Renzo Cestari; Neil Shepherd; Rajvinder Singh; Hubert J. Stein; Nicholas J. Talley; Jean–Paul Galmiche; Tony C.K. Tham; Peter Watson; Lisa Yerian; Massimo Rugge; Thomas W. Rice; John Hart; Stuart Gittens; David Hewin; Juergen Hochberger; Peter Kahrilas; Sean Preston; Richard Sampliner; Prateek Sharma; Robert Stuart; Kenneth Wang; Irving Waxman; Chris Abley; Duncan Loft; Ian Penman; Nicholas J. Shaheen; Amitabh Chak; Gareth Davies; Lorna Dunn; Yngve Falck–Ytter; John Decaestecker; Pradeep Bhandari; Christian Ell; S. Michael Griffin; Stephen Attwood; Hugh Barr; John Allen; Mark K. Ferguson; Paul Moayyedi; Janusz A.Z. Jankowski

doi:10.1053/j.gastro.2012.04.032

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Consensus Statements for Management of Barrett's Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process

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Consensus Statements for Management of Barrett's Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process

Cathy Bennett, Nimish Vakil, Jacques Bergman, Rebecca Harrison, Robert Odze, Michael Vieth, Scott Sanders, Laura Gay, Oliver Pech, Gaius Longcroft–Wheaton, …

Gastroenterology (New York, N.Y. 1943), Vol.143(2), pp.336-346

01/08/2012

DOI: https://doi.org/10.1053/j.gastro.2012.04.032

PMCID: PMC5538857

PMID: 22537613

Abstract

BADCAT

Esophageal Cancer

Systematic Analysis

Treatment Strategy

Esophageal adenocarcinoma (EA) is increasingly common among patients with Barrett's esophagus (BE). We aimed to provide consensus recommendations based on the medical literature that clinicians could use to manage patients with BE and low-grade dysplasia, high-grade dysplasia (HGD), or early-stage EA. We performed an international, multidisciplinary, systematic, evidence-based review of different management strategies for patients with BE and dysplasia or early-stage EA. We used a Delphi process to develop consensus statements. The results of literature searches were screened using a unique, interactive, Web-based data-sifting platform; we used 11,904 papers to inform the choice of statements selected. An a priori threshold of 80% agreement was used to establish consensus for each statement. Eighty-one of the 91 statements achieved consensus despite generally low quality of evidence, including 8 clinical statements: (1) specimens from endoscopic resection are better than biopsies for staging lesions, (2) it is important to carefully map the size of the dysplastic areas, (3) patients that receive ablative or surgical therapy require endoscopic follow-up, (4) high-resolution endoscopy is necessary for accurate diagnosis, (5) endoscopic therapy for HGD is preferred to surveillance, (6) endoscopic therapy for HGD is preferred to surgery, (7) the combination of endoscopic resection and radiofrequency ablation is the most effective therapy, and (8) after endoscopic removal of lesions from patients with HGD, all areas of BE should be ablated. We developed a data-sifting platform and used the Delphi process to create evidence-based consensus statements for the management of patients with BE and early-stage EA. This approach identified important clinical features of the diseases and areas for future studies.

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Title: Consensus Statements for Management of Barrett's Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process
Creators - without role: Cathy Bennett - Queens University
Nimish Vakil - University of Wisconsin School of Medicine and Public Health
Jacques Bergman - Amsterdam Medical Center, Amsterdam, The Netherlands
Rebecca Harrison - University Hospitals of Leicester, Leicester, UK
Robert Odze - Harvard Medical School
Michael Vieth - Klinikum Bayreuth, Bayreuth, Germany
Scott Sanders - Coventry
Laura Gay - Queen Mary University of London
Oliver Pech - Klinikum Bayreuth, Bayreuth, Germany
Gaius Longcroft–Wheaton - Queen Alexandra Hospital
Yvonne Romero - Mayo Clinic
John Inadomi - Washington University, Seattle, Washington
Jan Tack - KU Leuven
Douglas A. Corley - Kaiser Permanente
Hendrik Manner - HSK Hospital, Wiesbaden, Germany
Susi Green - Queen Alexandra Hospital
David Al Dulaimi - Redditch General Hospital, Redditch, UK
Haythem Ali - Maidstone and Tunbridge Wells NHS Trust
Bill Allum - Royal Marsden Hospital
Mark Anderson - City Hospital, Birmingham, UK and Sandwell Hospital, West Midlands, UK
Howard Curtis - Queen Marys Hospital, Sidcup, UK
Gary Falk - University of Pennsylvania
M. Brian Fennerty - Oregon Health & Science University
Grant Fullarton - Royal Infirmary, Glasgow, UK
Kausilia Krishnadath - Amsterdam Medical Center, Amsterdam, The Netherlands
Stephen J. Meltzer - Johns Hopkins University School of Medicine
David Armstrong - McMaster University
Robert Ganz - Bloomington Medical Centre, Bloomington, Minnesota
Gianpaolo Cengia - University of Brescia
James J. Going - Royal Infirmary, Glasgow, UK
John Goldblum - Cleveland Clinic
Charles Gordon - Royal Bournemouth Hospital
Heike Grabsch - University of Leeds
Chris Haigh - Wansbeck General Hospital
Michio Hongo - Tohoku University Hospital
David Johnston - Ninewells Hospital
Ricky Forbes–Young - Edinburgh Royal Infirmary
Elaine Kay - Trinity College Dublin
Philip Kaye - Digestive Diseases Centre, Nottingham University Hospital, Nottingham, UK
Toni Lerut - KU Leuven
Laurence B. Lovat - University College London, London, UK
Lars Lundell - Karolinska Institutet
Philip Mairs - Darrent Valley Hospital, Kent, UK
Tadakuza Shimoda - National Cancer Center, Tokyo, Japan
Stuart Spechler - University of Dallas
Stephen Sontag - Hines Veterans Affairs Hospital, Chicago, Illinois
Peter Malfertheiner - Magdeburg University, Magdeburg, Germany
Iain Murray - Royal Cornwall Hospitals, Truro, UK
Manoj Nanji - Queen Mary University of London
David Poller - Queen Alexandra Hospital
Krish Ragunath - Digestive Diseases Centre, Nottingham University Hospital, Nottingham, UK
Jaroslaw Regula - Institute of Oncology, Warsaw, Poland
Renzo Cestari - University of Brescia
Neil Shepherd - Gloucestershire Royal Hospitals, Gloucestershire, UK
Rajvinder Singh - University of Adelaide
Hubert J. Stein - Polyclinic Klinikum München, München, Germany
Nicholas J. Talley - University of Newcastle, Newcastle, Australia
Jean–Paul Galmiche - Nantes Université
Tony C.K. Tham - Ulster Hospital
Peter Watson - Queens University
Lisa Yerian - Cleveland Clinic
Massimo Rugge - University of Padova, Padua, Italy
Thomas W. Rice - Cleveland Clinic
John Hart - University of Chicago
Stuart Gittens - ECD Solutions, PO Box 862, Bridgetown, St. Michael, Barbados
David Hewin - Gloucestershire Royal Hospitals, Gloucestershire, UK
Juergen Hochberger - St. Bernward Hospital, Hildesheim, Germany
Peter Kahrilas - Northwestern University
Sean Preston - Barts Health NHS Trust
Richard Sampliner - University of Arizona
Prateek Sharma - University of Kansas
Robert Stuart - Oesophageal Cancer Fund, Dublin, Ireland
Kenneth Wang - Winneshiek Medical Center
Irving Waxman - University of Chicago
Chris Abley - University Hospitals of Leicester, Leicester, UK
Duncan Loft - Coventry
Ian Penman - Edinburgh Royal Infirmary
Nicholas J. Shaheen - University of North Carolina School of Medicine
Amitabh Chak - Case Western Reserve University
Gareth Davies - Harrogate District Hospital
Lorna Dunn - Royal Victoria Infirmary
Yngve Falck–Ytter - Louis Stokes Medical Center, Cleveland, Ohio
John Decaestecker - University Hospitals of Leicester, Leicester, UK
Pradeep Bhandari - Queen Alexandra Hospital
Christian Ell - Klinikum Bayreuth, Bayreuth, Germany
S. Michael Griffin - Royal Victoria Infirmary
Stephen Attwood - Durham University
Hugh Barr - Gloucestershire Royal Hospitals, Gloucestershire, UK
John Allen - University of Minnesota
Mark K. Ferguson - University of Chicago
Paul Moayyedi - McMaster University
Janusz A.Z. Jankowski - University Hospitals of Leicester, Leicester, UK
Publication Details: Gastroenterology (New York, N.Y. 1943), Vol.143(2), pp.336-346
Publisher: Elsevier Inc
Grant note: Janssen Cilag France Pentax Medical Inc AltanaPharma Shire Canada Cook Medical and BÂRRX Medical Warner-Chilcott Forest Eisai Limited Janssen Ortho Inc Abbott Laboratories XenoPort Inc Proctor & Gamble Olympus Canada Inc AstraZeneca Pfizer Gilead ADDEX Takeda Canada FALK BÂRRX Janssen Schering-Plough NPS Pharmaceuticals Axcan Pentax Nycomed Merck Olympus Keymed
Identifiers: 9921656608331
Academic Unit: King Abdulaziz University; King Saud Bin Abdulaziz University for Health Sciences
Language: English
Resource Type: Journal article