Comparing outcome of radiofrequency ablation in Barrett’s with high grade dysplasia and intramucosal carcinoma: a prospective multicenter UK registry

• DOI: 10.1055/s-0034-1392414
• Publication Date: 2015-06-30T23:25:18Z
• Authors: Rehan Haidry; Gideon Lipman; Matthew Banks; Mohammed Butt; Vinay Sehgal; David Graham; Jason Dunn; Abhinav Gupta; Rami Sweis; Haroon Miah; Danielle Morris; Howard Smart; Pradeep Bhandari; Robert Willert; Grant Fullarton; Jonathon Morris; Massimo Di Pietro; Charles Gordon; Ian Penman; High Barr; Praful Patel; Philip Boger; Neil Kapoor; Brinder Mahon; Jonathon Hoare; Ravi Narayanasamy; Dermot O’Toole; Edward Cheong; Natalie Direkze; Yeng Ang; Andrew Veitch; Anjan Dhar; David Nyalender; Krish Ragunath; Anthony Leahy; Mark Fullard; Manuel Rodriguez-...; Marco Novelli; Laurence Lovat
• Keywords: Intestinal metaplasia; Endoscopic mucosal resection; Barrett's esophagus

<b>Background and study aim:</b> Mucosal neoplasia arising in Barrett's esophagus can be successfully treated with endoscopic mucosal resection (EMR) followed by radiofrequency ablation (RFA). The aim of the was to compare clinical outcomes patients high grade dysplasia (HGD) or intramucosal cancer (IMC) at baseline from United Kingdom RFA registry. <b>Patients methods:</b> Prior RFA, visible lesions nodularity were removed entirely EMR. Thereafter, underwent every 3 months until all mucosa ablated developed (end points). Biopsies taken 12 when end points reached. <b>Results:</b> A total 515 patients, 384 HGD 131 IMC, completed treatment. EMR performed for more frequently IMC cohort than (77 % vs. 47 %; <i>P</i> < 0.0001). 12-month complete response intestinal metaplasia almost identical two cohorts (HGD 88 76 %, respectively; 87 75 = 0.7). Progression invasive not significantly different 1.8 3.8 0.19). trend towards slightly worse medium-term durability may emerging (<i>P</i> 0.08). In definitely associated superior compared alone 0.01). <b>Conclusion:</b> Registry reports on therapy neoplasia, representing real-life outcomes. Patients likely have requiring initial those HGD, carry a higher risk progression medium term. data consolidate approach ensuring that these undergo thorough work-up, including prior necessary.