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@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 and 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, vol.~28, No~2, p.~149-155. ISSN~1841-8724. Available from: https://dx.doi.org/10.15403/jgld-174.
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