Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus

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Standard

Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus. / Åkerström, Johan Hardvik; Santoni, Giola; von Euler Chelpin, My; Ness-Jensen, Eivind; Kauppila, Joonas H.; Holmberg, Dag; Lagergren, Jesper.

I: Gastroenterology, Bind 166, Nr. 1, 2024, s. 132-138.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Åkerström, JH, Santoni, G, von Euler Chelpin, M, Ness-Jensen, E, Kauppila, JH, Holmberg, D & Lagergren, J 2024, 'Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus', Gastroenterology, bind 166, nr. 1, s. 132-138. https://doi.org/10.1053/j.gastro.2023.08.050

APA

Åkerström, J. H., Santoni, G., von Euler Chelpin, M., Ness-Jensen, E., Kauppila, J. H., Holmberg, D., & Lagergren, J. (2024). Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus. Gastroenterology, 166(1), 132-138. https://doi.org/10.1053/j.gastro.2023.08.050

Vancouver

Åkerström JH, Santoni G, von Euler Chelpin M, Ness-Jensen E, Kauppila JH, Holmberg D o.a. Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus. Gastroenterology. 2024;166(1):132-138. https://doi.org/10.1053/j.gastro.2023.08.050

Author

Åkerström, Johan Hardvik ; Santoni, Giola ; von Euler Chelpin, My ; Ness-Jensen, Eivind ; Kauppila, Joonas H. ; Holmberg, Dag ; Lagergren, Jesper. / Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus. I: Gastroenterology. 2024 ; Bind 166, Nr. 1. s. 132-138.

Bibtex

@article{70918128b5f242639796cdf63c27eb5f,

title = "Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus",

abstract = "Background & Aims: Antireflux treatment is recommended to reduce esophageal adenocarcinoma in patients with Barrett's esophagus. Antireflux surgery (fundoplication) counteracts gastroesophageal reflux of all types of carcinogenic gastric content and reduces esophageal acid exposure to a greater extent than antireflux medication (eg, proton pump inhibitors). We examined the hypothesis that antireflux surgery prevents esophageal adenocarcinoma to a larger degree than antireflux medication in patients with Barrett's esophagus. Methods: This multinational and population-based cohort study included all patients with a diagnosis of Barrett's esophagus in any of the national patient registries in Denmark (2012–2020), Finland (1987–1996 and 2010–2020), Norway (2008–2020), or Sweden (2006–2020). Patients who underwent antireflux surgery were compared with nonoperated patients using antireflux medication. The risk of esophageal adenocarcinoma was calculated using multivariable Cox regression, providing hazard ratios (HRs) and 95% CIs adjusted for age, sex, country, calendar year, and comorbidity. Results: The cohort consisted of 33,939 patients with Barrett's esophagus. Of these, 542 (1.6%) had undergone antireflux surgery. During up to 32 years of follow-up, the overall HR was not decreased in patients having undergone antireflux surgery compared with nonoperated patients using antireflux medication, but rather increased (adjusted HR, 1.9; 95% CI, 1.1–3.5). In addition, HRs did not decrease with longer follow-up, but instead increased for each follow-up category, from 1.8 (95% CI, 0.6–5.0) within 1–4 years of follow-up to 4.4 (95% CI, 1.4–13.5) after 10–32 years of follow-up. Conclusions: Patients with Barrett's esophagus who undergo antireflux surgery do not seem to have a lower risk of esophageal adenocarcinoma than those using antireflux medication.",

keywords = "Esophageal Neoplasm, Fundoplication, Multinational, Population-Based, Proton Pump Inhibitor",

author = "{\AA}kerstr{\"o}m, {Johan Hardvik} and Giola Santoni and {von Euler Chelpin}, My and Eivind Ness-Jensen and Kauppila, {Joonas H.} and Dag Holmberg and Jesper Lagergren",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

doi = "10.1053/j.gastro.2023.08.050",

language = "English",

volume = "166",

pages = "132--138",

journal = "Gastroenterology",

issn = "0016-5085",

publisher = "Elsevier",

number = "1",

}

RIS

TY - JOUR

T1 - Antireflux Surgery Versus Antireflux Medication and Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus

AU - Åkerström, Johan Hardvik

AU - Santoni, Giola

AU - von Euler Chelpin, My

AU - Ness-Jensen, Eivind

AU - Kauppila, Joonas H.

AU - Holmberg, Dag

AU - Lagergren, Jesper

PY - 2024

Y1 - 2024

N2 - Background & Aims: Antireflux treatment is recommended to reduce esophageal adenocarcinoma in patients with Barrett's esophagus. Antireflux surgery (fundoplication) counteracts gastroesophageal reflux of all types of carcinogenic gastric content and reduces esophageal acid exposure to a greater extent than antireflux medication (eg, proton pump inhibitors). We examined the hypothesis that antireflux surgery prevents esophageal adenocarcinoma to a larger degree than antireflux medication in patients with Barrett's esophagus. Methods: This multinational and population-based cohort study included all patients with a diagnosis of Barrett's esophagus in any of the national patient registries in Denmark (2012–2020), Finland (1987–1996 and 2010–2020), Norway (2008–2020), or Sweden (2006–2020). Patients who underwent antireflux surgery were compared with nonoperated patients using antireflux medication. The risk of esophageal adenocarcinoma was calculated using multivariable Cox regression, providing hazard ratios (HRs) and 95% CIs adjusted for age, sex, country, calendar year, and comorbidity. Results: The cohort consisted of 33,939 patients with Barrett's esophagus. Of these, 542 (1.6%) had undergone antireflux surgery. During up to 32 years of follow-up, the overall HR was not decreased in patients having undergone antireflux surgery compared with nonoperated patients using antireflux medication, but rather increased (adjusted HR, 1.9; 95% CI, 1.1–3.5). In addition, HRs did not decrease with longer follow-up, but instead increased for each follow-up category, from 1.8 (95% CI, 0.6–5.0) within 1–4 years of follow-up to 4.4 (95% CI, 1.4–13.5) after 10–32 years of follow-up. Conclusions: Patients with Barrett's esophagus who undergo antireflux surgery do not seem to have a lower risk of esophageal adenocarcinoma than those using antireflux medication.

AB - Background & Aims: Antireflux treatment is recommended to reduce esophageal adenocarcinoma in patients with Barrett's esophagus. Antireflux surgery (fundoplication) counteracts gastroesophageal reflux of all types of carcinogenic gastric content and reduces esophageal acid exposure to a greater extent than antireflux medication (eg, proton pump inhibitors). We examined the hypothesis that antireflux surgery prevents esophageal adenocarcinoma to a larger degree than antireflux medication in patients with Barrett's esophagus. Methods: This multinational and population-based cohort study included all patients with a diagnosis of Barrett's esophagus in any of the national patient registries in Denmark (2012–2020), Finland (1987–1996 and 2010–2020), Norway (2008–2020), or Sweden (2006–2020). Patients who underwent antireflux surgery were compared with nonoperated patients using antireflux medication. The risk of esophageal adenocarcinoma was calculated using multivariable Cox regression, providing hazard ratios (HRs) and 95% CIs adjusted for age, sex, country, calendar year, and comorbidity. Results: The cohort consisted of 33,939 patients with Barrett's esophagus. Of these, 542 (1.6%) had undergone antireflux surgery. During up to 32 years of follow-up, the overall HR was not decreased in patients having undergone antireflux surgery compared with nonoperated patients using antireflux medication, but rather increased (adjusted HR, 1.9; 95% CI, 1.1–3.5). In addition, HRs did not decrease with longer follow-up, but instead increased for each follow-up category, from 1.8 (95% CI, 0.6–5.0) within 1–4 years of follow-up to 4.4 (95% CI, 1.4–13.5) after 10–32 years of follow-up. Conclusions: Patients with Barrett's esophagus who undergo antireflux surgery do not seem to have a lower risk of esophageal adenocarcinoma than those using antireflux medication.

KW - Esophageal Neoplasm

KW - Fundoplication

KW - Multinational

KW - Population-Based

KW - Proton Pump Inhibitor

U2 - 10.1053/j.gastro.2023.08.050

DO - 10.1053/j.gastro.2023.08.050

M3 - Journal article

C2 - 37690771

AN - SCOPUS:85177094465

VL - 166

SP - 132

EP - 138

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 1

ER -

ID: 384017592