Original ResearchFull Report: Clinical—Alimentary TractRemission of Barrett's Esophagus With Early Neoplasia 5 Years After Radiofrequency Ablation With Endoscopic Resection: A Netherlands Cohort Study
Section snippets
Patient Selection
Patients were initially included if they had endoscopically visible BE with histology proven HGIN and/or early-stage cancer demonstrated on at least 2 separate endoscopies. Patients were treated per one of the following study protocols (Table 1):
- 1.
The first pilot study (AMC-I) on circumferential RFA using the HALO360 ablation device, with earlier en-bloc endoscopic resection allowed, of HGIN and/or early-stage cancer in patients with BE segment between 2 and 10 cm.11
- 2.
The second prospective study
Patient Characteristics and Initial Treatment
Fifty-five patients (45 men) with a mean age of 65 years (±9.6 years) were included, with a median BE length of C4M5 cm (IQR, C1−7 to M4−8 cm). Forty patients (72%) underwent endoscopic resection of visible abnormalities before the first RFA treatment. After RFA treatment, CR-neoplasia/CR-IM was achieved in 54 of 55 (98%) patients. One patient underwent surgery for persisting HGIN, as scarring after previous endoscopic resection treatment made it impossible to perform escape endoscopic
Discussion
In this prospective cohort of patients who reached CR-neoplasia and CR-IM after endoscopic resection/RFA, sustained remission was observed in 93% of 46 patients (95% CI: 82.5−97.8) who were followed for at least 5 years. Overall, sustained remission was demonstrated in 94% of 54 patients (95% CI: 84.9−98.1) during a median follow-up of 5 years. All recurrences of neoplasia observed during this trial were detected at an early stage during endoscopic follow-up and could be managed endoscopically;
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Conflicts of interest This author discloses the following: Jacques J. G. H. M. Bergman has received grant support and medical supplies from BÂRRX Medical/Covidien, Cook Medical, Olympus Endoscopy, and AstraZeneca. The remaining authors disclose no conflicts.
Funding This work was supported, in part, by BÂRRX Medical, Sunnyvale, CA.