Help
Subscribe


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

 28 July 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

 28 July 2016 
Hep B screening and immunosuppressive therapy
 28 July 2016 
Pancreatitis after ERCP
 28 July 2016 
HCV eradication in cirrhotic patients
 27 July 2016 
Bleeding GI recurrence with aspirin use
 27 July 2016 
IBD during pregnancy
 27 July 2016 
Gluten exposure in patients with celiac disease
 26 July 2016 
Post-infectious IBS after C. diff
 26 July 2016 
Gut microbiota and IBD
 26 July 2016 
Neighborhood variation in the use of laparoscopy for colon cancer
 25 July 2016 
Antibiotic prophylaxis for open colectomies
 25 July 2016 
Steroids in eosinophilic esophagitis
 25 July 2016 
Prevention of post-ERCP pancreatitis
 22 July 2016 
Upper GI lesions at primary diagnosis in IBD
 22 July 2016 
Duodenal villous atrophy and celiac disease
 22 July 2016 
Fecal calprotectin and IBD
 21 July 2016 
Radiofrequency ablation in Barrett's
 21 July 2016 
HCV eradication and inflammation in cirrhotic patients
 21 July 2016 
Surveillance of Barrett's
 20 July 2016 
Nonselective β-blockers and survival in cirrhosis
 20 July 2016 
Adolescent body mass index and and colorectal cancer risk
 20 July 2016 
Genetic biomarkers and IBD treatment response
 19 July 2016 
Prevention of chemotherapy-induced nausea and vomiting
 19 July 2016 
Screening diabetic patients for NAFLD
 19 July 2016 
Longterm clinical follow-up of living liver donors
 18 July 2016 
Rectal neuroendocrine tumors
 18 July 2016 
Liver cancer prediction scores in Hep B
 18 July 2016 
Liver stiffness measurement in chronic liver disease
 15 July 2016 
Patient reported outcomes in celiac disease
 15 July 2016 
Tonsillectomy and IBD risk
 15 July 2016 
Trainee IBD education in the USA
 14 July 2016 
Screening for familial pancreatic cancer
 14 July 2016 
Fecal calprotection for IBD prognosis
 14 July 2016 
Perianal surgery risk in Crohn's
 13 July 2016 
Psychological comorbidity and postinfectious IBS
 13 July 2016 
Lung transplant outcomes in Hep C
 13 July 2016 
Graft selection strategy in living donor liver transplants
 12 July 2016 
Therapy for iron deficiency anemia in IBD
 12 July 2016 
Surveillance endoscopy in Barrett's esophagus
 12 July 2016 
Treatment of pediatric acute liver failure
 11 July 2016 
Transition to adulthood in celiac disease
 11 July 2016 
Factors that influence access to liver transplant
 11 July 2016 
Disturbed sleep and IBS
 08 July 2016 
Mortality and peptic ulcers
 08 July 2016 
Statins and cirrhosis in Hep B
 08 July 2016 
Genetic risk score and body mass index
 07 July 2016 
Predicting food triggers in eosinophilic esophagitis
 07 July 2016 
Extraperitoneal vs transperitoneal colostomy for hernia
 07 July 2016 
Predictors fecal transplant failure in C. diff infection
 06 July 2016 
Therapies for Hep B cure
 06 July 2016 
Hospital volume and liver cancer survival
 06 July 2016 
Adverse events after outpatient colonoscopy
 05 July 2016 
Non-invasive scoring systems for fibrosis in NAFLD
 05 July 2016 
Exercise and gastroesophageal reflux
 05 July 2016 
Colorectal surgery and dialysis
 04 July 2016 
Guidelines on PPI and NSAID prescription
 04 July 2016 
Rectal cancer surgery checklist
 04 July 2016 
Autoimmunity in eosinophilic esophagitis and families
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 01 July 2016 
Aspirin and colorectal cancer

Blackwell Publishing


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