Open AccessComparative outcomes of radiofrequency ablation for Barrett's oesophagus with different baseline histology
Author(s) -
Tan Wei Keith,
Rattan Arti,
O’Donovan Maria,
Nuckcheddy Tara,
Alias Bincy,
Sujendran Vijay,
Pietro Massimiliano
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640617752183
Subject(s) - medicine , histology , dysplasia , intestinal metaplasia , radiofrequency ablation , gastroenterology , barrett's oesophagus , ablation , surgery , adenocarcinoma , cancer
Background Radiofrequency ablation (RFA) is currently recommended for dysplastic Barrett's oesophagus (BO); however, there are limited data on treatment response when stratified by baseline histology. Objective The objective of this article is to evaluate RFA outcomes and durability for BO with different baseline histology. Methods Patients treated with RFA between 2007 and 2017 at a single institution were retrospectively included. Outcome measures were: (a) complete remission of dysplasia (CRD) and intestinal metaplasia (CRIM) at 18 months, (b) complication rate and (c) durability of CRD and CRIM. Results A total of 148 patients underwent RFA, of whom 113 completed the treatment protocol (21 low‐grade dysplasia (LGD), 46 high‐grade dysplasia (HGD) and 46 intramucosal carcinoma (IMC)). CRD and CRIM were achieved in 94.7% and 78.8% of patients, respectively. When stratified by baseline histology, there was no significant difference in CRD between groups (LGD, 95.2%; HGD, 95.7%; and IMC, 93.5%; p = 0.89). Similarly, there was no significant difference in CRIM between groups (LGD, 71.4%; HGD, 76.1% and IMC, 87.0%; p = 0.39). CRD and CRIM durability at 24 months for LGD, HGD and IMC were 100%, 97.7% and 100% (log rank p = 0.31), and 100%, 89.0% and 95.5%, respectively (log rank p = 0.62). Conclusion Baseline histology is not a predictor of RFA response. Once CRD and CRIM are achieved, these effects are durable over time.