Follow-up (FU) strategies after endoscopic eradication therapy (EET) for Barrett’s neoplasia do not consider the risk of mortality from causes other than esophageal adenocarcinoma (EAC). We aimed to evaluate this risk during long-term FU, and to assess whether the Charlson Comorbidity Index (CCI) can predict mortality. We included all patients with successful EET from the nationwide Barrett registry in the Netherlands. Data were merged with National Statistics for accurate mortality data. We evaluated annual mortality rates (AMRs, per 1000 person-years) and standardized mortality ratio for other-cause mortality. Performance of the CCI was evaluated by discrimination and calibration. We included 1154 patients with a mean age of 64 years (±9). During median 59 months (p25–p75 37–91; total 6375 person-years), 154 patients (13%) died from other causes than EAC (AMR, 24.1; 95% CI, 20.5–28.2), most commonly non-EAC cancers (n = 58), cardiovascular (n = 31), or pulmonary diseases (n = 26). Four patients died from recurrent EAC (AMR, 0.5; 95% CI, 0.1–1.4). Compared with the general Dutch population, mortality was significantly increased for patients in the lowest 3 age quartiles (ie, age <71 years). Validation of CCI in our population showed good discrimination (Concordance statistic, 0.78; 95% CI, 0.72–0.84) and fair calibration. The other-cause mortality risk after successful EET was more than 40 times higher (48; 95% CI, 15–99) than the risk of EAC-related mortality. Our findings reveal that younger post-EET patients exhibit a significantly reduced life expectancy when compared with the general population. Furthermore, they emphasize the strong predictive ability of CCI for long-term mortality after EET. This straightforward scoring system can inform decisions regarding personalized FU, including appropriate cessation timing. (NL7039)

中文翻译：

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巴雷特瘤内镜根除治疗成功后无关死亡率的发生率和预测

Barrett 瘤形成内镜根除治疗 (EET) 后的随访 (FU) 策略不考虑食管腺癌 (EAC) 以外原因导致的死亡风险。我们的目的是评估长期 FU 期间的这种风险，并评估查尔森合并症指数 (CCI) 是否可以预测死亡率。我们纳入了来自荷兰全国 Barrett 登记处的所有成功 EET 的患者。数据与国家统计数据合并以获得准确的死亡率数据。我们评估了年死亡率（AMR，每千人年）和其他原因死亡率的标准化死亡率。 CCI 的性能通过辨别和校准进行评估。我们纳入了 1154 名患者，平均年龄为 64 岁 (±9)。在中位 59 个月期间（p25-p75 37-91；总共 6375 人年），154 名患者 (13%) 死于 EAC 以外的其他原因（AMR，24.1；95% CI，20.5-28.2），最常见的是非 EAC癌症 (n = 58)、心血管疾病 (n = 31) 或肺部疾病 (n = 26)。 4 名患者死于复发性 EAC（AMR，0.5；95% CI，0.1-1.4）。与一般荷兰人口相比，最低 3 个年龄四分位数（即年龄 <71 岁）的患者死亡率显着增加。我们人群中 CCI 的验证显示出良好的区分度（一致性统计量，0.78；95% CI，0.72-0.84）和公平的校准。成功 EET 后的其他原因死亡风险比 EAC 相关死亡风险高 40 倍以上（48；95% CI，15-99）。我们的研究结果表明，与一般人群相比，年轻的 EET 治疗后患者的预期寿命显着缩短。此外，他们强调 CCI 对 EET 后长期死亡率的强大预测能力。这种简单的评分系统可以为有关个性化 FU 的决策提供信息，包括适当的停止时间。 (NL7039)