{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:18:08Z","timestamp":1780409888094,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["BRC\u20101215\u201020014"],"award-info":[{"award-number":["BRC\u20101215\u201020014"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Study Aims<\/jats:title>\n                    <jats:p>Endoscopic resection (ER) is curative for early\u2010stage oesophageal adenocarcinoma (OAC) without high\u2010risk features. Piecemeal endoscopic mucosal resection (pEMR) prevents assessment of lateral margins, complicating risk estimation for neoplastic recurrence. We investigated the risk factors for residual and recurrent OAC post\u2010pEMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a longitudinal study of two independent patient cohorts: the test cohort who underwent piecemeal or en\u2010bloc ER (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0140) and the validation cohort who underwent pEMR only (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a089). Inclusion criteria were: OAC stage T1a or low\u2010risk T1b, no lympho\u2010vascular invasion, and R0 resection. The primary outcome was residual OAC at first post\u2010ER endoscopy, and secondary outcomes were residual neoplasia (high\u2010grade dysplasia and\/or OAC), recurrence of neoplasia at any post\u2010ER endoscopy, and remission of neoplasia, dysplasia and metaplasia at most recent endoscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the test cohort, the incidence of neoplastic recurrence was higher in patients treated with pEMR (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a054, 49%) versus en\u2010bloc ER (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a07, 23%) (\n                      <jats:italic>p\u00a0=<\/jats:italic>\n                      \u00a00.021). The percentage of pEMR specimens with OAC was an independent risk factor for residual OAC at the first post\u2010pEMR endoscopy (OR for a 10% increase\u00a0=\u00a01.24, CI\u00a0=\u00a01.03\u20131.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.025). A 50% cut\u2010off of pEMR specimens with OAC was optimal to predict residual OAC (specificity\u00a0=\u00a00.68, sensitivity\u00a0=\u00a00.63). Rates of residual (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039) and recurrent (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0052) OAC were higher when &gt;\u00a050% of pEMR specimens were involved by OAC. In the validation cohort, recurrent OAC was also more frequent when cancer burden was &gt;\u00a050% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High cancer burden on pEMR specimens correlates with the risk of residual OAC. Post\u2010pEMR site check before endoscopic ablation is recommended if more than 50% of pEMR specimens show OAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70140","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:51:00Z","timestamp":1761763860000},"page":"1703-1714","source":"Crossref","is-referenced-by-count":1,"title":["Cancer Burden on Piecemeal Endoscopic Resection of Early Adenocarcinoma in Barrett's Oesophagus Correlates With the Risk of Neoplastic Recurrence"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2439-2256","authenticated-orcid":false,"given":"Grace J.","family":"Hattersley","sequence":"first","affiliation":[{"name":"School of Clinical Medicine University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas V.","family":"Hadjinicolaou","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"},{"name":"Department of Gastroenterology Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-9949","authenticated-orcid":false,"given":"Andrea","family":"Sorge","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Conceicao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1584-8026","authenticated-orcid":false,"given":"Sally","family":"Pan","sequence":"additional","affiliation":[{"name":"Early Cancer Institute Department of Oncology University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Sujendran","sequence":"additional","affiliation":[{"name":"Cambridge Oesophago\u2010Gastric Center Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Bradford Teaching Hospital  Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Histopathology Nottingham University Hospitals  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Mundre","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Bradford Teaching Hospital  Bradford 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