Benefit of radiofrequency ablation after widespread endoscopic resection of neoplastic Barrett's esophagus in daily practice.

Details

Serval ID
serval:BIB_90EEB1392CF8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Benefit of radiofrequency ablation after widespread endoscopic resection of neoplastic Barrett's esophagus in daily practice.
Journal
Annals of gastroenterology
Author(s)
Godat S., Marx M., Caillol F., Robert M., Autret A., Bories E., Pesenti C., Ratone J.P., Schoepfer A., Poizat F., Giovannini M.
ISSN
1108-7471 (Print)
ISSN-L
1108-7471
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
35
Number
1
Pages
34-41
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
High-grade dysplasia (HGD) and intramucosal carcinoma (IMC) in Barrett's esophagus (BE) are now well-established indications for endoscopic resection (ER). Radiofrequency ablation (RFA) can be combined with ER in case of flat or long-segment BE ablation. We report here our experience of complementary RFA after widespread ER of neoplastic BE in daily practice.
We retrospectively reviewed data of 89 patients, treated between 2006 and 2013 by ER alone (group 1) or by ER combined with RFA (group 2).
Fifty-five patients in group 1 (7F/48M, mean age 68 years) underwent widespread ER with eradication of residual non-dysplastic BE. Complete eradication of HGD/IMC and intestinal metaplasia (IM) was achieved in 32/32 (100%) and 48/55 (87.3%) patients, respectively. Thirty-four patients in group 2 (3F/31M, mean age 67 years) had a multimodal treatment strategy, with widespread ER followed by RFA. Mean Prague classification of BE in this group was significantly longer (C4.4M6.6 vs. C2.7M4.5, P<0.001). Complete eradication of HGD/IMC and non-dysplastic BE was confirmed in 26/27 (96.3%) and 20/34 (58.8%) patients, respectively. There was no significant difference between groups concerning adverse events (16.4% vs. 23.5%, P=0.58) or recurrence rate of HGD/IMC (9.1% vs. 14.7%, P=0.42). The mismatch rate between preoperative and final histological diagnosis was high in both groups, at 45.5% and 26.5%.
A combination of ER and RFA can treat significantly longer neoplastic BE than ER alone, with the same efficiency and safety. Widespread ER, in contrast, is the only method of obtaining a reliable histological diagnosis.
Keywords
Barrett’s esophagus, endoscopic resection, esophageal cancer, high-grade dysplasia, radiofrequency ablation
Pubmed
Web of science
Open Access
Yes
Create date
07/01/2022 18:30
Last modification date
09/02/2022 7:33
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