Radiofrequency Ablation in Patients with Barrett's
Esophagus-related Neoplasia - Long-Term Outcomes in the Czech
National Database

J 2019

Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database

KRAJCIOVA, Jana, Martin JANICKO, Premysl FALT, Jan GREGAR, Stepan SUCHANEK et. al.

Základní údaje

Originální název

Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database

Autoři

KRAJCIOVA, Jana (203 Česká republika), Martin JANICKO (703 Slovensko, garant), Premysl FALT (203 Česká republika), Jan GREGAR (203 Česká republika), Stepan SUCHANEK, Ondřej NGO (203 Česká republika, domácí), Marek KOLLAR (203 Česká republika), Ondrej URBAN (203 Česká republika), Vlastimil PROCHAZKA (203 Česká republika), Miroslav ZAVORAL (203 Česká republika), Julius SPICAK (203 Česká republika) a Jan MARTINEK (203 Česká republika)

Vydání

Journal of Gastrointestinal and Liver Diseases, CLUJ-NAPOCA, MEDICAL UNIV PRESS, 2019, 1841-8724

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Rumunsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.351

Kód RIV

RIV/00216224:14110/19:00112951

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.15403/jgld-174

UT WoS

000475570900006

Klíčová slova anglicky

Barrett's esophagus related neoplasia; radiofrequency ablation; neo-Z-line; intestinal metaplasia

Štítky

14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 17. 2. 2020 07:42, Mgr. Tereza Miškechová

Anotace

V originále

Background & Aims: Radiofrequency ablation (RFA) with/without endoscopic resection (ER) is the standard endoscopic treatment modality for Barrett's esophagus (BE) related neoplasia (BORN). The main aim of this study was to assess the long-term outcomes of RFA in patients with BORN. Methods: We retrospectively analyzed the prospectively collected data from the Czech national database. Main outcomes were: complete remission of neoplasia (CR-N), complete remission of intestinal metaplasia (CR-IM), recurrence of both neoplasia and IM, and safety. Results: From a total of 170 patients with BORN treated with RFA, 136 patients were analyzed. They were followed up for a median of 27.5 months. Fifty-six patients (41%) had low-grade intraepithelial neoplasia (LGIN), 46 (34%) had high-grade intraepithelial neoplasia (HGIN) and 34 (25%) had early adenocarcinoma (EAC). RFA was combined with previous ER in 65 patients (48%). CR-IM and CR-N were achieved in 77.9% (95% CI 70.0-84.6%) and 98.5% (95% CI 94.8-99.8%). Among 30 patients without CR-IM, 22 (73%) did not have macroscopic signs of BE. Recurrent neoplasia was detected in 4.5% of patients (6/134) and 15% (16/106) experienced a recurrence of IM at the level of the neo-Z-line. Diagnosis of cancer was an independent risk factor for recurrent IM after RFA (OR 7.0, 95% CI 1.6-30.9, p<0.0005). Conclusion: RFA is highly effective in achieving remission in patients with BORN. A significant proportion of patients did not achieve CR-IM or had a recurrence of IM despite macroscopically absent BE. Recurrence of neoplasia was infrequent but not negligible, thus, patients after successful RFA still require endoscopic surveillance.

Citovat

KRAJCIOVA, Jana, Martin JANICKO, Premysl FALT, Jan GREGAR, Stepan SUCHANEK, Ondřej NGO, Marek KOLLAR, Ondrej URBAN, Vlastimil PROCHAZKA, Miroslav ZAVORAL, Julius SPICAK a Jan MARTINEK. Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database. Journal of Gastrointestinal and Liver Diseases. CLUJ-NAPOCA: MEDICAL UNIV PRESS, 2019, roč. 28, č. 2, s. 149-155. ISSN 1841-8724. Dostupné z: https://dx.doi.org/10.15403/jgld-174.

@article{1622816,
   author = {Krajciova, Jana and Janicko, Martin and Falt, Premysl and Gregar, Jan and Suchanek, Stepan and Ngo, Ondřej and Kollar, Marek and Urban, Ondrej and Prochazka, Vlastimil and Zavoral, Miroslav and Spicak, Julius and Martinek, Jan},
   article_location = {CLUJ-NAPOCA},
   article_number = {2},
   doi = {http://dx.doi.org/10.15403/jgld-174},
   keywords = {Barrett's esophagus related neoplasia; radiofrequency ablation; neo-Z-line; intestinal metaplasia},
   language = {eng},
   issn = {1841-8724},
   journal = {Journal of Gastrointestinal and Liver Diseases},
   title = {Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database},
   url = {http://dx.doi.org/10.15403/jgld-174},
   volume = {28},
   year = {2019}
}

TY  - JOUR
ID  - 1622816
AU  - Krajciova, Jana - Janicko, Martin - Falt, Premysl - Gregar, Jan - Suchanek, Stepan - Ngo, Ondřej - Kollar, Marek - Urban, Ondrej - Prochazka, Vlastimil - Zavoral, Miroslav - Spicak, Julius - Martinek, Jan
PY  - 2019
TI  - Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database
JF  - Journal of Gastrointestinal and Liver Diseases
VL  - 28
IS  - 2
SP  - 149-155
EP  - 149-155
PB  - MEDICAL UNIV PRESS
SN  - 18418724
KW  - Barrett's esophagus related neoplasia
KW  - radiofrequency ablation
KW  - neo-Z-line
KW  - intestinal metaplasia
UR  - http://dx.doi.org/10.15403/jgld-174
L2  - http://dx.doi.org/10.15403/jgld-174
N2  - Background & Aims: Radiofrequency ablation (RFA) with/without endoscopic resection (ER) is the standard endoscopic treatment modality for Barrett's esophagus (BE) related neoplasia (BORN). The main aim of this study was to assess the long-term outcomes of RFA in patients with BORN. Methods: We retrospectively analyzed the prospectively collected data from the Czech national database. Main outcomes were: complete remission of neoplasia (CR-N), complete remission of intestinal metaplasia (CR-IM), recurrence of both neoplasia and IM, and safety. Results: From a total of 170 patients with BORN treated with RFA, 136 patients were analyzed. They were followed up for a median of 27.5 months. Fifty-six patients (41%) had low-grade intraepithelial neoplasia (LGIN), 46 (34%) had high-grade intraepithelial neoplasia (HGIN) and 34 (25%) had early adenocarcinoma (EAC). RFA was combined with previous ER in 65 patients (48%). CR-IM and CR-N were achieved in 77.9% (95% CI 70.0-84.6%) and 98.5% (95% CI 94.8-99.8%). Among 30 patients without CR-IM, 22 (73%) did not have macroscopic signs of BE. Recurrent neoplasia was detected in 4.5% of patients (6/134) and 15% (16/106) experienced a recurrence of IM at the level of the neo-Z-line. Diagnosis of cancer was an independent risk factor for recurrent IM after RFA (OR 7.0, 95% CI 1.6-30.9, p<0.0005). Conclusion: RFA is highly effective in achieving remission in patients with BORN. A significant proportion of patients did not achieve CR-IM or had a recurrence of IM despite macroscopically absent BE. Recurrence of neoplasia was infrequent but not negligible, thus, patients after successful RFA still require endoscopic surveillance.
ER  -

KRAJCIOVA, Jana, Martin JANICKO, Premysl FALT, Jan GREGAR, Stepan SUCHANEK, Ondřej NGO, Marek KOLLAR, Ondrej URBAN, Vlastimil PROCHAZKA, Miroslav ZAVORAL, Julius SPICAK a Jan MARTINEK. Radiofrequency Ablation in Patients with Barrett's Esophagus-related Neoplasia - Long-Term Outcomes in the Czech National Database. \textit{Journal of Gastrointestinal and Liver Diseases}. CLUJ-NAPOCA: MEDICAL UNIV PRESS, 2019, roč.~28, č.~2, s.~149-155. ISSN~1841-8724. Dostupné z: https://dx.doi.org/10.15403/jgld-174.

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