Effects of preceding endoscopic mucosal resection on the efficacy and safety of radiofrequency ablation for treatment of Barrett's esophagus: results from the United States Radiofrequency Ablation Registry

• DOI: 10.1111/dote.12386
• Publication Date: 2015-06-30T03:19:31Z
• Authors: N. Li; S. Pasricha; W. J. Bulsiewicz; R. E. Pruitt; S. Komanduri; H. C. Wolfsen; G. W. Chmielewski; F. S. Corbett; K. J. Chang; N. J. Shaheen
• Keywords: Endoscopic mucosal resection; Barrett's esophagus

The effects of preceding endoscopic mucosal resection (EMR) on the efficacy and safety radiofrequency ablation (RFA) for treatment nodular Barrett's esophagus (BE) is poorly understood. Prior studies have been limited to case series from individual tertiary care centers. We report results a large, multicenter registry. assessed EMR RFA BE with advanced neoplasia (high-grade dysplasia or intramucosal carcinoma) using US Registry, nationwide study patients treated at 148 institutions. Safety outcomes included stricture, gastrointestinal bleeding, hospitalization. Efficacy complete eradication intestinal metaplasia (CEIM), (CED), number treatments needed achieve CEIM. Analyses comparing before undergoing alone were performed Student's t-test, Chi-square test, logistic regression, Kaplan-Meier analysis. Four hundred six BE, 857 only non-nodular BE. total complication rates 8.4% in EMR-before-RFA group 7.2% RFA-only (P = 0.48). Rates hospitalization not significantly different between alone. CEIM was achieved 84% RFA, 0.96). CED 94% 92% group, respectively 0.17). Durability did differ groups. effective safe. neither diminished nor increased rate compared who had no EMR. Preceding associated poorer RFA.