Critical appraisal:Nurkin SJ, Nava HR, Yendamuri S, Levea CM, Nwogu CE, Groman A, et al 2013

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Critical Appraisal

Article being appraised

Nurkin SJ, Nava HR, Yendamuri S, Levea CM, Nwogu CE, Groman A, et al. Outcomes of endoscopic resection for high-grade dysplasia and esophageal cancer. Surg Endosc 2013 Nov 14 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24232046.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

81


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
No, but objective measures used
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
3 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

Jutta's tick icon.png Included



Comments

This is a retrospective, single-institution case series of 81 patients with Barrett's oesophagus undergoing ER of oesophageal lesions. In patients with
HGD, at the time of last endoscopy, the complete eradication rate of HGD was 84 % and cancer-specific survival was 100 % over a mean follow up of 3.25 years. Patients with T1a and negative deep margins on ER had a recurrence-free and cancer-specific survival of 100 %. There were seven patients with T1b and negative margins on ER. Three patients underwent esophagectomy; final
pathology revealed no residual malignancy or lymph node metastasis. The authors concluded that ER can be performed safely and can adequately stage and often treat patients with HGD and superficial cancers.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


Jutta's tick icon.png This appraisal has been completed.


Article
Nurkin SJ, Nava HR, Yendamuri S, Levea CM, Nwogu CE, Groman A, et al. Outcomes of endoscopic resection for high-grade dysplasia and esophageal cancer. Surg Endosc 2013 Nov 14 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/24232046.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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