How Good is Radiofrequency Ablation of Barrett Esophagus?

According to the latest data? Good, with a low but persistent risk for recurrence of dysplasia or metaplasia. Not good enough to forgo endoscopic surveillance.

The primary goal of ablative strategies in Barrett esophagus (BE) is to reduce the risk for progression to esophageal adenocarcinoma (EAC). Recent study results (NEJM JW Gastroenterol Nov 4 2011) showed lasting effects from radiofrequency ablation (RFA) after 2 years, particularly in patients with high- or low-grade dysplasia (HGD or LGD). Now, three new cohort studies expand the evidence on clinical outcomes of RFA.

In a U.S. study, 592 patients (HGD or EAC, 71%; LGD, 15%; non-dysplastic, 14%) received RFA every 4 months until achieving complete remission of intestinal metaplasia (CRIM). In 76% of patients reassessed post-RFA, 51% achieved CRIM in 2 years, but 33% had recurrence within the following 2 years.

In a U.K. study, 335 patients (HG…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors