Observational Study
Copyright ©The Author(s) 2021.
World J Gastrointest Oncol. Apr 15, 2021; 13(4): 279-294
Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.279
Table 3 Survey results of respondents comparing Japan vs rest of Asia
Question
Option
Japan
Rest of Asia
P value
Q1. What is your preferred endoscopic landmark of the esophagogastric junction?Squamo-columnar Junction (Z-line)27.4%59.5%< 0.001
Proximal margin of gastric folds12.6%27.8%
Distal margin of palisade vessels59.0%10.0%
Diaphragmatic pinch1.0%2.7%
Q2. What is your preferred endoscopic definition of Barrett’s esophagus?Length of columnar lined epithelium ≥ 2 cm23.2%35.9%< 0.001
Length of columnar lined epithelium ≥ 1 cm12.6%34.7%
Any length of columnar lined epithelium in the esophagus64.2%29.3%
Q3. How often do you use the Prague C and M criteria in your assessment of Barrett’s esophagus?All the time11.3%22.4%< 0.001
> 70% of the time4.5%15.4%
30%-70% of the time8.7%15.4%
< 30% of the time29.4%30.9%
Never46.1%15.8%
Q4. How comfortable are you with endoscopic assessment (white-light with or without advanced imaging technology) in the diagnosis of Barrett’s esophagus? 100% comfortable17.1%8.1%< 0.001
> 70% comfortable51.6%37.5%
30%-70% comfortable24.2%34.4%
< 30% comfortable6.5%15.4%
Not at all0.6%4.6%
Q5. What is your preferred histologic definition of Barrett’s esophagus?Any columnar tissue35.2%39.4%< 0.001
Specialized intestinal metaplasia16.8%36.3%
Gastric metaplasia16.1%18.9%
No histological confirmation required31.9%5.4%
Q6. In your practice, how regular do you survey your long-segment Barrett’s esophagus without dysplasia?Every 2 yr82.3%57.1%< 0.001
Every 3 yr4.8%22.8%
Every 5 yr1.6%4.6%
None at all11.3%15.4%
Q7. How often do you follow the Seattle protocol (i.e. four-quadrant biopsies every 2 cm) in your biopsies of Barrett’s esophagus during surveillance endoscopy? All the time2.6%10.8%< 0.001
> 70% of the time4.2%8.1%
30%-70% of the time2.3%17.4%
< 30% of the time17.7%44.4%
Never73.2%19.3%
Q8. What is your preferred treatment of Barrett’s esophagus without dysplasia?Lifelong PPI 15.8%27.8%< 0.001
PPI only when patient has symptoms of gastroesophageal reflux or evidence of esophagitis81.9%64.5%
Radiofrequency Ablation1.0%3.9%
Anti-reflux procedure (e.g. fundoplication)1.3%3.9%
Q9. For Barrett’s esophagus patients whose biopsies showed indefinite for dysplasia, your preferred approach is:Confirm with second pathologist and repeat endoscopy after a course of PPI32.6%59.5%< 0.001
Surveillance 6-monthly37.7%21.2%
Surveillance yearly29.0%18.1%
Surveillance 3-5 yearly0.6%1.2%
Q10. For Barrett’s esophagus patients without a lesion but whose biopsies showed low grade dysplasia, your preferred approach is: Surveillance 6-monthly61.9%47.9%< 0.001
Surveillance yearly21.9%20.5%
Surveillance 3-5 yearly1.0%2.7%
Ablative therapy, e.gv., radiofrequency, cryotherapy, argon plasma coagulation1.0%19.7%
Endoscopic mucosal resection1.6%6.6%
Endoscopic submucosal dissection12.6%2.7%
Q11. For Barrett’s esophagus patients without a lesion but whose biopsies showed high grade dysplasia, your preferred treatment is: Endoscopic mucosal resection12.6%22.4%< 0.001
Endoscopic submucosal dissection83.5%49.8%
Ablative therapy, e.g., radiofrequency, cryotherapy, argon plasma coagulation2.6%21.6%
Surgery, e.g., esophagectomy1.3%6.2%

  • Citation: Kew GS, Soh AYS, Lee YY, Gotoda T, Li YQ, Zhang Y, Chan YH, Siah KTH, Tong D, Law SYK, Ruszkiewicz A, Tseng PH, Lee YC, Chang CY, Quach DT, Kusano C, Bhatia S, Wu JCY, Singh R, Sharma P, Ho KY. Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region. World J Gastrointest Oncol 2021; 13(4): 279-294
  • URL: https://www.wjgnet.com/1948-5204/full/v13/i4/279.htm
  • DOI: https://dx.doi.org/10.4251/wjgo.v13.i4.279