Mo1815 Predictors of Durable Treatment Response After Radiofrequency Ablation for Barrett's Esophagus Associated Intramucosal Adenocarcinoma

Agoston, Agoston T.; Dulai, Parambir S.; Strauss, Adam C.; Fudman, David; Hagen, Catherine; Abrams, Julian A.; Forcione, David G.; Jajoo, Kunal; Saltzman, John R.; Odze, Robert D.; Lauwers, Gregory Y.; Gordon, Stuart R.; Lightdale, Charles J.; Rothstein, Richard I.; Srivastava, Amitabh

doi:10.1016/s0016-5085(14)62406-9

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“…As is inherent to a prospective registry, some data were missing. For example there were no data on multifocal dysplasia and on maximum depth of invasion in microns from the surface; this could have been interesting since intramucosal carcinoma involving > 50 % of the metaplastic mucosa is an adverse prognostic indicator for resistance to ablation [28]. The pathology reports of control biopsies specified whether was stroma was included in the biopsy or not, which was the fact in about 10 % of the cases.…”

Section: Euro II Trialmentioning

confidence: 99%

Efficacy and safety of radiofrequency ablation of Barrett’s esophagus in the absence of reimbursement: a multicenter prospective Belgian registry

Vliebergh

Deprez²,

Looze

et al. 2018

Endoscopy

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Background Radiofrequency ablation (RFA), combined with endoscopic resection, can be used as a primary treatment for low grade dysplasia, high grade dysplasia, and early esophageal adenocarcinoma (EAC) in Barrett’s esophagus (BE). The aim of the Belgian RFA registry is to capture the real-life outcome of endoscopic therapy for BE with RFA and to assess efficacy and safety outside study protocols, in the absence of reimbursement. Patients and methods Between February 2008 and January 2017, data from 7 different expert centers were prospectively collected in the registry. Efficacy outcomes included complete remission of intestinal metaplasia (CR-IM), complete remission of dysplasia (CR-D), and durability of remission. Safety outcomes included immediate and late adverse events. Results 684 RFA procedures in 342 different patients were registered. Of these, 295 patients were included in the efficacy analysis, with CR-IM achieved in 88 % and CR-D in 93 %, in per-protocol analysis; corresponding rates in intention-to-treat analysis were 82 % and 87 %, respectively. Sustained remission was seen in 65 % with a median (interquartile range) follow-up of 25 (12 – 47) months. No risk factors for recurrent disease were identified. Immediate complications occurred in 4 % of all procedures and 6 % of all patients, whereas late complications occurred in 9 % of all procedures and in 20 % of all patients. Conclusions Data from the Belgian registry confirm that RFA in combination with endoscopic resection is an efficient treatment for BE with dysplasia or early EAC. In the absence of reimbursement, more rescue treatments are used, not compromising outcome. Since there is recurrent disease after CR-IM in 35 %, surveillance endoscopy remains necessary.

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Section: Euro II Trialmentioning

confidence: 99%