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Radiofrequency ablation of Barrett's esophagus: outcomes of 429 patients from a multicenter community practice registry.
Endoscopy. 2010 Apr; 42(4):272-8.E

Abstract

BACKGROUND AND STUDY AIMS

The use of radiofrequency ablation (RFA) for complete eradication of Barrett's esophagus has shown promise in trials conducted at predominantly tertiary academic centers; however less is known regarding outcomes in the community. We evaluated the safety and efficacy of RFA for Barrett's esophagus delivered in a community practice setting.

PATIENTS AND METHODS

This was a multicenter registry conducted in community-based gastroenterology practices. Patients had confirmed intestinal metaplasia with or without dysplasia on biopsy of a Barrett's esophagus. Intervention was step-wise RFA with follow-up esophageal biopsies. Endpoints were histology-based; complete response was defined as all biopsies at most recent endoscopy negative for intestinal metaplasia (CR-IM) or dysplasia (CR-D). Three cohorts were reported: 1) safety cohort, all patients; 2) efficacy cohort A, patients with at least one biopsy session after initial treatment; 3) efficacy cohort B, patients with at least one biopsy session > or = 1 year after initial treatment.

RESULTS

The safety cohort included 429 patients (71 % men, median age 59 years, median Barrett's segment 3.0 cm). There were no serious adverse events (bleeding, perforation, death), and a stricture occurred after 1.1 % of cases (2.1 % of patients). In efficacy cohort A (n = 338), CR-IM and CR-D were achieved in 72 % and 89 % of patients, respectively (median follow-up 9 months). In efficacy cohort B (n = 137), CR-IM and CR-D were achieved in 77 % and 100 % of patients, respectively (median follow-up 20 months).

CONCLUSIONS

In this multicenter registry conducted at four community-based practices, the observed safety and efficacy outcomes associated with RFA for Barrett's esophagus are comparable to those previously reported in multicenter trials from predominantly tertiary academic centers.

Authors+Show Affiliations

The Center for GI Health, Cancer Prevention, Management and Nutritional Therapy, A Division of Atlanta Gastroenterology Associates, LLC, Atlanta, Atlanta, Georgia, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

20146164

Citation

Lyday, W D., et al. "Radiofrequency Ablation of Barrett's Esophagus: Outcomes of 429 Patients From a Multicenter Community Practice Registry." Endoscopy, vol. 42, no. 4, 2010, pp. 272-8.
Lyday WD, Corbett FS, Kuperman DA, et al. Radiofrequency ablation of Barrett's esophagus: outcomes of 429 patients from a multicenter community practice registry. Endoscopy. 2010;42(4):272-8.
Lyday, W. D., Corbett, F. S., Kuperman, D. A., Kalvaria, I., Mavrelis, P. G., Shughoury, A. B., & Pruitt, R. E. (2010). Radiofrequency ablation of Barrett's esophagus: outcomes of 429 patients from a multicenter community practice registry. Endoscopy, 42(4), 272-8. https://doi.org/10.1055/s-0029-1243883
Lyday WD, et al. Radiofrequency Ablation of Barrett's Esophagus: Outcomes of 429 Patients From a Multicenter Community Practice Registry. Endoscopy. 2010;42(4):272-8. PubMed PMID: 20146164.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency ablation of Barrett's esophagus: outcomes of 429 patients from a multicenter community practice registry. AU - Lyday,W D, AU - Corbett,F S, AU - Kuperman,D A, AU - Kalvaria,I, AU - Mavrelis,P G, AU - Shughoury,A B, AU - Pruitt,R E, Y1 - 2010/02/09/ PY - 2010/2/11/entrez PY - 2010/2/11/pubmed PY - 2010/8/6/medline SP - 272 EP - 8 JF - Endoscopy JO - Endoscopy VL - 42 IS - 4 N2 - BACKGROUND AND STUDY AIMS: The use of radiofrequency ablation (RFA) for complete eradication of Barrett's esophagus has shown promise in trials conducted at predominantly tertiary academic centers; however less is known regarding outcomes in the community. We evaluated the safety and efficacy of RFA for Barrett's esophagus delivered in a community practice setting. PATIENTS AND METHODS: This was a multicenter registry conducted in community-based gastroenterology practices. Patients had confirmed intestinal metaplasia with or without dysplasia on biopsy of a Barrett's esophagus. Intervention was step-wise RFA with follow-up esophageal biopsies. Endpoints were histology-based; complete response was defined as all biopsies at most recent endoscopy negative for intestinal metaplasia (CR-IM) or dysplasia (CR-D). Three cohorts were reported: 1) safety cohort, all patients; 2) efficacy cohort A, patients with at least one biopsy session after initial treatment; 3) efficacy cohort B, patients with at least one biopsy session > or = 1 year after initial treatment. RESULTS: The safety cohort included 429 patients (71 % men, median age 59 years, median Barrett's segment 3.0 cm). There were no serious adverse events (bleeding, perforation, death), and a stricture occurred after 1.1 % of cases (2.1 % of patients). In efficacy cohort A (n = 338), CR-IM and CR-D were achieved in 72 % and 89 % of patients, respectively (median follow-up 9 months). In efficacy cohort B (n = 137), CR-IM and CR-D were achieved in 77 % and 100 % of patients, respectively (median follow-up 20 months). CONCLUSIONS: In this multicenter registry conducted at four community-based practices, the observed safety and efficacy outcomes associated with RFA for Barrett's esophagus are comparable to those previously reported in multicenter trials from predominantly tertiary academic centers. SN - 1438-8812 UR - https://www.unboundmedicine.com/medline/citation/20146164/Radiofrequency_ablation_of_Barrett's_esophagus:_outcomes_of_429_patients_from_a_multicenter_community_practice_registry_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1243883 DB - PRIME DP - Unbound Medicine ER -