NEW YORK (Reuters Health) - A new model that predicts recurrence after endoscopic eradication of Barrett's esophagus (BE) with dysplasia or early cancer can help establish a personalized follow-up strategy for patients, researchers say.
The model, which has been externally validated, is available at https://barrett-recurrence.shinyapps.io/Barrett.
"Once complete Barrett's eradication is achieved, the chances for neoplastic recurrence are so small that we significantly reduce the burden of endoscopic follow-up procedures in the vast majority of cases," Dr. Jacques J.G.H.M. Bergman of Amsterdam University Medical Center told Reuters Health by email. "Those with an increased risk can be identified with our prediction model."
Clinicians can start implementing the model now, he said, to "reduce the burden of healthcare and unnecessary worries (for) our patients." Guidelines should incorporate the model, he added, "to ensure the quality of the actual endoscopic eradication by centralizing care in high-volume expert centers, and then allowing the currently too-strict follow-up regimen only for the small subset of cases who have a significant recurrence risk."
As reported in Gastroenterology, Dr. Bergman and colleagues built the model using data from the Dutch Barrett Expert Center Registry, which captures outcomes from all BE patients undergoing endoscopic treatment in the Netherlands. Input included predictors related to demographics, severity of reflux, histologic status at baseline, and treatment characteristics.
