Help
Subscribe


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

 01 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

 29 April 2016 
Crohn's disease associated genes
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Racial disparities in survival from colon cancer
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 27 April 2016 
Dust mite and human GI tract
 27 April 2016 
Celiac disease in adults
 27 April 2016 
Ultra-short celiac disease
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
IBS and microscopic colitis
 26 April 2016 
Polyp detection during colonoscopy
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Acceptance of Liver transplant center organ offers
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naÔve children
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
HBV during immunosuppressive therapies
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 05 April 2016 
Colorectal cancer risk with serrated polyps
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 31 March 2016 
Management of Barrettís esophagus
 30 March 2016 
Depression and symptoms in IBS
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 29 March 2016 
Statins and survival in esophageal cancer
 29 March 2016 
Infant feeding practices and celiac disease
 25 March 2016 
Medical therapy and neoplasia regression in familial adenomatous polyposis
 25 March 2016 
Medical therapy compliance and ulcerative colitis recurrence
 25 March 2016 
Predicting outcomes of drug-induced acute liver failure
 24 March 2016 
Thrombocytopenia and multi-organ system failure in acute liver failure
 24 March 2016 
Patients with ulcerative colitis and their concerns
 24 March 2016 
Prediction of relapses in IBD
 23 March 2016 
Thiopurine therapy in IBD
 23 March 2016 
Early colonoscopy for lower GI bleeds
 23 March 2016 
Treatment with immunomodulators and biologics in ulcerative colitis
 22 March 2016 
Bile acid diarrhea
 22 March 2016 
Psoriasis induced by anti-TNF therapy in IBD
 22 March 2016 
Predicting mortality in acute liver failure
 21 March 2016 
Gut microbiota and risk of pneumococcal pneumonia

Blackwell Publishing


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