Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Radiofrequency ablation vs endoscopic surveillance for Barrett esophagus

A study in this week's issue of the Journal of the American Medical Association compares radiofrequency ablation with endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia.

News image

Barrett esophagus containing low-grade dysplasia is associated with an increased risk of developing esophageal adenocarcinoma, a cancer with a rapidly increasing incidence in the western world.

Dr Nadine and colleagues investigated whether endoscopic radiofrequency ablation could decrease the rate of neoplastic progression.

Multicenter randomized clinical trial that enrolled 136 patients with a confirmed diagnosis of Barrett esophagus containing low-grade dysplasia at 9 European sites between 2007 and 2011.

Eligible patients were randomly assigned in a 1:1 ratio to either endoscopic treatment with radiofrequency ablation (ablation) or endoscopic surveillance (control).

Ablation was performed with the balloon device for circumferential ablation of the esophagus or the focal device for targeted ablation, with a maximum of 5 sessions allowed.

The researchers primary outcome was neoplastic progression to high-grade dysplasia or adenocarcinoma during a 3-year follow-up since randomization.

Adverse events occurred in 19% of patients receiving ablation
Journal of the American Medical Association

Secondary outcomes were complete eradication of dysplasia and intestinal metaplasia and adverse events.

The research team reported that 68 patients were randomized to receive ablation, and 68 to receive control.

Ablation reduced the risk of progression to high-grade dysplasia or adenocarcinoma by 25%, and the risk of progression to adenocarcinoma by 7%.

Among patients in the ablation group, complete eradication occurred in 93% for dysplasia and 88% for intestinal metaplasia compared with 28% for dysplasia, and 0% for intestinal metaplasia among patients in the control group.

Treatment-related adverse events occurred in 19% of patients receiving ablation.

The researchers found that the most common adverse event was stricture, occurring in 12% of patients receiving ablation, all resolved by endoscopic dilation.

The data and safety monitoring board recommended early termination of the trial due to superiority of ablation for the primary outcome and the potential for patient safety issues if the trial continued.

Dr Nadine's team concludes, "In this randomized trial of patients with Barrett esophagus and a confirmed diagnosis of low-grade dysplasia, radiofrequency ablation resulted in a reduced risk of neoplastic progression over 3 years of follow-up."

JAMA 2014; 311(12): 1209-1217
27 March 2014

Go to top of page Email this page Email this page to a colleague

 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 24 May 2016 
New therapies for NASH
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 23 May 2016 
Cancer after colectomy in IBD
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 19 May 2016 
Predicting outcome in ulcerative colitis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
C. difficile in ulcerative colitis patients
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 13 May 2016 
Inactivated oral cholera vaccine
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Age and disease presentation with Crohn's disease
 11 May 2016 
Prognosis after colorectal cancer resection
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 04 May 2016 
Anti-TNF therapy for IBD
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
PPIs and gut microbiota
 03 May 2016 
Surgery vs medical therapy for GERD
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 29 April 2016 
Crohn's disease associated genes
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 28 April 2016 
Racial disparities in survival from colon cancer
 27 April 2016 
Celiac disease in adults

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us