{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:19:39Z","timestamp":1767705579554,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Barrett's oesophagus predisposes individuals to oesophageal adenocarcinoma (OAC), with the risk of progression to malignancy increasing with the degree of dysplasia, categorized as either low\u2010grade dysplasia\u00a0(LGD) or high\u2010grade dysplasia (HGD). The reported incidence of progression to OAC in LGD ranges from 0.02% to 11.43% per annum. In patients with LGD, Australian guidelines recommend 6\u2010monthly endoscopic surveillance. We aimed to describe the surveillance practices within a tertiary centre, and to determine the predictive value of surveillance as well as other risk factors for progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Endoscopy and pathology databases were searched over a 10\u2010year period to collate all cases of Barrett's oesophagus with LGD. Medical records were reviewed to document patient factors and endoscopic and histologic details. Because follow\u2010up times varied greatly, survival analysis techniques were employed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010nine patients were found to have LGD. Thirteen patients (22.0%) progressed to either HGD or OAC (10 (16.9%) and three (5.1%) respectively); the annual incidence rates of progression to HGD\/OAC and OAC were 5.5% and 1.1% respectively. All patients who developed OAC had non\u2010guideline\u2010adherent surveillance. A Cox model found only two predictors of progression: (i) guideline\u2010adherent surveillance, performed in 16 (27.1%), detected progression to HGD\/OAC four times earlier than non\u2010guideline\u2010adherent surveillance (95% confidence interval (CI) =\u20091.3\u201312.3; <jats:italic>P<\/jats:italic> =\u20090.016). (ii) The detection of visible lesions at exit endoscopy independently predicted progression (hazard ratio\u2009=\u20096.5; 95% CI\u2009=\u20091.9\u201322.8; <jats:italic>P<\/jats:italic> =\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Barrett's oesophagus with LGD poses a significant risk of progression to HGD\/OAC. Guideline\u2010recommended surveillance is effective, but is difficult to adhere to. Clinical predictors for those who are more likely to progress are yet to be defined.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16532","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T11:14:12Z","timestamp":1726830852000},"page":"1867-1875","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of patients with <scp>Barrett<\/scp>'s oesophagus with low\u2010grade dysplasia undergoing endoscopic surveillance in a tertiary centre: a retrospective cohort study"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6487-3710","authenticated-orcid":false,"given":"Luke J.","family":"Vlismas","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Gosford Hospital  Gosford New South Wales Australia"},{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Potter","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Loewenthal","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"},{"name":"Department of Medicine John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelleigh","family":"Allport","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Gillies","sequence":"additional","affiliation":[{"name":"Surgical Services John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dane","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Philcox","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Bollipo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas J.","family":"Talley","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00796"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.01.009"},{"key":"e_1_2_8_4_1","unstructured":"KendallB.Clinical Practice Guidelines for the Diagnosis and Management of Barrett's Oesophagus and Early Oesophageal Adenocarcinoma [Online]. Australia: Cancer Council Australia; 2014 [updated 2014; cited 2021 May 16]. Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Barrett%27s"},{"key":"e_1_2_8_5_1","unstructured":"SpechlerS.Barrett's Esophagus: Epidemiology Clinical Manifestations and Diagnosis [Online]. United States: Wolters Kluwer; 2020 [updated 2020; cited 2021 May 16]. Available from URL:https:\/\/www.uptodate.com\/contents\/barretts-esophagus-epidemiology-clinical-manifestations-and-diagnosis"},{"key":"e_1_2_8_6_1","unstructured":"SpechlerS.Barrett's Esophagus: Pathogenesis and Malignant Transformation [Online]. United States: Wolters Kluwer; 2020 [updated 2020; cited 2021 May 16]. Available from URL:https:\/\/www.uptodate.com\/contents\/barretts-esophagus-pathogenesis-and-malignant-transformation"},{"key":"e_1_2_8_7_1","unstructured":"SpechlerS.Barrett's Esophagus: Surveillance and Management [Online]. United States: Wolters Kluwer; 2020 [updated 2020; cited 2021 May 16]. 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