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.

Basic information

Original name

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

Authors

KRAJCIOVA, Jana (203 Czech Republic), Martin JANICKO (703 Slovakia, guarantor), Premysl FALT (203 Czech Republic), Jan GREGAR (203 Czech Republic), Stepan SUCHANEK, Ondřej NGO (203 Czech Republic, belonging to the institution), Marek KOLLAR (203 Czech Republic), Ondrej URBAN (203 Czech Republic), Vlastimil PROCHAZKA (203 Czech Republic), Miroslav ZAVORAL (203 Czech Republic), Julius SPICAK (203 Czech Republic) and Jan MARTINEK (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30219 Gastroenterology and hepatology

Country of publisher

Romania

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.351

RIV identification code

RIV/00216224:14110/19:00112951

Organization unit

Faculty of Medicine

DOI

UT WoS

000475570900006

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 17/2/2020 07:42, Mgr. Tereza Miškechová

Abstract

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.