Long-term remission of nondysplastic Barrett's esophagus after multipolar electrocoagulation ablation: report of 139 patients with 10 years of follow-up

Risk of recurrence of Barrett’s esophagus after successful endoscopic therapy

“…Among the 41 included studies, the primary endoscopic treatment modality was RFA in 21 studies, 9,12,14,15,18,21,22,27,29,30,32,39-41,43,47,49,51,53,54 APC in 7 studies, 33,34,36,45,46,48,52 EMR in 7 studies, 20,21,31,37,42,44,50 PDT in 2 studies, 7,19 multipolar electrocoagulation in 2 studies, 13,28 laser in 1 study, 35 and cryotherapy in 1 study. 38 Twenty-three studies were from North America, 9,12,14,15,18-20,22,27,30,32,35,37-39,41-44,47,53,54 15 studies were from Europe, 7,13,21,31,33,34,40,45,46,48-52 and 1 study each was from South America, 28 Africa, 36 and the Asia-Pacific. 29 Four studies included NDBE patients only, 13,28,34,52 and 16 studies included only DBE ± early neoplasia patients, 7,19-21,29,31,37,39,40,42,44,49,51,53,54 with the remainder including NDBE and DBE patients.…”

“…38 Twenty-three studies were from North America, 9,12,14,15,18-20,22,27,30,32,35,37-39,41-44,47,53,54 15 studies were from Europe, 7,13,21,31,33,34,40,45,46,48-52 and 1 study each was from South America, 28 Africa, 36 and the Asia-Pacific. 29 Four studies included NDBE patients only, 13,28,34,52 and 16 studies included only DBE ± early neoplasia patients, 7,19-21,29,31,37,39,40,42,44,49,51,53,54 with the remainder including NDBE and DBE patients.…”

“…Among the RFA studies, 7 studies were deemed high quality, 9,12,18,32,39,49,54 11 studies were deemed medium quality 14,21,22,29,40,41,43,47,51,53 and 3 studies were deemed low quality. 15,27,30 When all endoscopic modalities were included, 9 studies were deemed high quality, 9,12,18,32,37,39,42,49,54 22 studies were deemed medium quality, 7,13,14,19-22,28,29,31,34,35,40,41,43,44,47,50,51,53 and 10 studies were deemed low quality. 15,27,30,33,36,38,45,46,48,52 …”

“…Substantial heterogeneity (I 2 = 93%) was seen in the analysis. On meta-analysis of the 28 studies that reported histology of recurrence, 7,9,12-15,18,22,28-32,34,35,37,39,42-50,54 the pooled incidence of DBE was 1.3% per patient-year (95% CI, .8-1.7) (Fig. 3B) and of HGD/EAC was .8% per patient-year (95% CI, .5-1.1) (Fig.…”

“…Only 3.4% of recurrences needed surgical treatment in 20 studies where data were available, whereas the rest were treated endoscopically. 7,9,12-14,18,22,28-31,33,35,37,39,46,48,49,53 In the 17 studies that reported if recurrences where endoscopically visible, 9,13,21,28,31-35,37,43-45,49-51 only 58% of recurrences were endoscopically visible. The remaining 42% of recurrences were noted in biopsy specimens from normal-appearing mucosa.…”