Abstract
BackgroundWe aim to investigate factors that may contribute to failure of eradication of dysplastic Barrett’s Esophagus among patients undergoing radiofrequency ablation treatment.MethodsA retrospective review of patients undergoing radiofrequency ablation for treatment of Barrett’s Esophagus was performed. Data analyzed included patient demographics, medical history, length of Barrett’s Esophagus, number of radiofrequency ablation sessions, and histopathology. Subsets of patients achieving complete eradication were compared with those not achieving complete eradication.ResultsA total of 107 patients underwent radiofrequency ablation for Barrett’s Esophagus, the majority white, overweight, and male. Before treatment, 63 patients had low-grade dysplasia, and 44 patients had high-grade dysplasia or carcinoma. Complete eradication was achieved in a majority of patients (57% for metaplasia, and 76.6% for dysplasia). Failure of eradication occurred in 15.7% of patients. The median number of radiofrequency ablation treatments in patients achieving complete eradication was 3 sessions, compared to 4 sessions for failure of eradication (p = 0.06). Barrett’s esophagus length of more than 5 cm was predictive of failure of eradication (p < 0.001).ConclusionsRadiofrequency ablation for dysplastic Barrett’s Esophagus is a proven and effective treatment modality, associated with a high rate of complete eradication. Our rates of eradication from a center starting an ablation program are comparable to previously published studies. Length of Barrett’s segment > 5 cm was found to be predictive of failure of eradication in patients undergoing radiofrequency ablation.
Highlights
We aim to investigate factors that may contribute to failure of eradication of dysplastic Barrett’s Esophagus among patients undergoing radiofrequency ablation treatment
Barrett’s Esophagus (BE) is a condition in which the stratified squamous epithelium that lines the distal esophagus is replaced by metaplastic columnar epithelium that predisposes to the development of dysplasia and adenocarcinoma [1]
The goals of this study were as follows: (1) to determine factors that may predict failure of complete eradication (CE)-IM and complete eradication of dysplasia (CE-D) in patients treated with radiofrequency ablation (RFA), and (2) to report the rates of complete eradication of intestinal metaplasia (CE-IM) and CE-D at a large institution that recently began offering RFA and compare them to those previously published in the literature
Summary
We aim to investigate factors that may contribute to failure of eradication of dysplastic Barrett’s Esophagus among patients undergoing radiofrequency ablation treatment. A relatively recent addition to Despite high rates of eradication, as many as one-third of patients experience recurrence after complete eradication [10]. Some patients do not respond to RFA or require multiple sessions to obtain complete eradication. While some have not been able to determine any significant predictors of response to therapy [13], others have found that active reflux disease, longer history of dysplasia, increased hiatal hernia size as well as increased length of BE are all predictors of RFA failure [14,15,16]
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