Barrett's Esophagus Progression Cut By Radiofrequency Ablation
(HealthDay News) — Radiofrequency ablation reduces the risk for neoplastic progression in patients with Barrett's esophagus with low-grade dysplasia, according to a study published in the March 26 issue of the Journal of the American Medical Association.
K. Nadine Phoa, MD, from University of Amsterdam, and colleagues randomly assigned (1:1) 136 patients with Barrett's esophagus containing low-grade dysplasia to either endoscopic treatment with radiofrequency ablation (ablation) or endoscopic surveillance (control).
The researchers found that ablation reduced the risk of progression to high-grade dysplasia or adenocarcinoma by 25.0% (P<0.001), and the risk of progression to adenocarcinoma by 7.4% (P=0.03). Complete eradication occurred in 92.6% of the ablation group for dysplasia and 88.2% for intestinal metaplasia, compared to 27.9 and 0% in the control group, respectively (P<0.001). There were significantly more treatment-related adverse events in the ablation group (19.1%; P<0.001), with stricture being the most common (11.8%). Early termination of the trial was recommended by the data and safety monitoring board due to superiority of ablation for the primary outcome and the potential for patient safety issues.
"In this randomized trial of patients with Barrett's esophagus and a confirmed diagnosis of low-grade dysplasia, radiofrequency ablation resulted in a reduced risk of neoplastic progression over three years of follow-up," the authors write.
One author disclosed financial ties to the pharmaceutical industry.