In NEJM this week, researchers in Denmark report their findings from a study of the incidence of adenocarcinoma in patients with Barrett's esophagus. The team analyzed data from all Barrett's esophagus patients in Denmark from 1992 to 2009 and found that Barrett's esophagus is indeed a strong risk factor for esophageal adenocarcinoma. However, the researchers also found that the absolute annual risk of 0.12 percent was much lower than the assumed risk of 0.5 percent, which is the basis for current surveillance guidelines for clinicians. "Data from the current study call into question the rationale for ongoing surveillance in patients who have Barrett's esophagus without dysplasia," the authors write.
Also in NEJM this week, an international team of researchers investigates the effects of adjuvant therapy with zoledronic acid in breast cancer. The team randomly assigned 3,360 patients to receive standard adjuvant therapy either with or without zoledronic acid. After a median follow-up of 59 months, there was no significant difference in disease-free survival between the two groups. The number of deaths in both groups was also similar, the researchers write, resulting overall survival rates of 85.4 percent in the zoledronic acid group and 83.1 percent in the control group. "These findings do not support the routine use of zoledronic acid in the adjuvant management of breast cancer," the authors write.