Comparative outcomes of radiofrequency ablation for Barrett's oesophagus with different baseline histology. Issue 5 (1st June 2018)

• Record Type: Journal Article
• Authors: Tan, Wei Keith; Rattan, Arti; O'Donovan, Maria; Nuckcheddy, Tara; Alias, Bincy; Sujendran, Vijay; di Pietro, Massimiliano
• Is Part Of: United European Gastroenterology journal. Volume 6:Issue 5(2018)
• Page Start: 662
• Page End: 668
• Publication Date: 2018-06-01
• Subjects: Barrett's oesophagus -- radiofrequency ablation -- low-grade dysplasia -- high-grade dysplasia -- intramucosal carcinoma; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640617752183
• Languages: English
• ISSNs: 2050-6406

Abstract

Abstract : Background: Radiofrequency ablation (RFA) is currently recommended for dysplastic Barrett's oesophagus (BO); however, there are limited data on treatment response when stratified by baseline histology. Objective: The objective of this article is to evaluate RFA outcomes and durability for BO with different baseline histology. Methods: Patients treated with RFA between 2007 and 2017 at a single institution were retrospectively included. Outcome measures were: (a) complete remission of dysplasia (CRD) and intestinal metaplasia (CRIM) at 18 months, (b) complication rate and (c) durability of CRD and CRIM. Results: A total of 148 patients underwent RFA, of whom 113 completed the treatment protocol (21 low‐grade dysplasia (LGD), 46 high‐grade dysplasia (HGD) and 46 intramucosal carcinoma (IMC)). CRD and CRIM were achieved in 94.7% and 78.8% of patients, respectively. When stratified by baseline histology, there was no significant difference in CRD between groups (LGD, 95.2%; HGD, 95.7%; and IMC, 93.5%; p = 0.89). Similarly, there was no significant difference in CRIM between groups (LGD, 71.4%; HGD, 76.1% and IMC, 87.0%; p = 0.39). CRD and CRIM durability at 24 months for LGD, HGD and IMC were 100%, 97.7% and 100% (log rank p = 0.31), and 100%, 89.0% and 95.5%, respectively (log rank p = 0.62). Conclusion: Baseline histology is not a predictor of RFA response. Once CRD and CRIM are achieved, these effects are durable over time.