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Surgical Endoscopy

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13-12-2023 | Barrett Esophagus

Durability of radiofrequency ablation for long-segment and ultralong-segment Barrett’s esophagus over 10 years

Authors: Chu Luan Nguyen, David Tovmassian, Michael Zhou, Doruk Seyfi, Suzanna Gooley, Gregory L. Falk

Published in: Surgical Endoscopy | Issue 3/2024

Abstract

Background

Long-term durability data for radiofrequency ablation (RFA) to prevent esophageal adenocarcinoma in long-segment (LSBE) and ultralong-segment Barrett’s esophagus (ULSBE) is lacking. This study aimed to determine 10-year cancer progression, eradication, and complication rates in LSBE and ULSBE patients treated with RFA.

Methods

Single-surgeon prospective database of patients with LSBE (≥ 3 to < 8 cm) and ULSBE (≥ 8 cm) who underwent RFA (2001–2021) were retrospectively analyzed. Ten-year cancer progression calculated with Kaplan–Meier analysis. Eradication rates, including complete remission of dysplasia (CR-D) and intestinal metaplasia (CR-IM), and rates of recurrence and complications, compared between LSBE and ULSBE groups.

Results

Ten years after starting treatment, the cancer rate was 14.3% in 56 patients. CR-D and CR-IM rates were 87.5% and 67.9%, respectively. Relapse rates from CR-D were 1.8% and 3.6% from CR-IM. Eradication rates for dysplasia in LSBE and ULSBE patients (90.6% versus 83.3%) and IM (71.9% versus 62.5%) were not significantly different. ULSBE patients required higher mean number of ablation sessions for IM eradication (4.7 versus 3.7, p = 0.032), while complication rates including strictures (4.2% versus 6.2%), perforation (0 versus 0), and bleeding (4.2% versus 3.1%), were similar between ULSBE and LSBE patients, respectively. On multivariate analysis, shorter Barrett’s segment and baseline low-grade dysplasia were associated with increased likelihood for eradication of IM and dysplasia. A total number of ablation sessions or endoscopic resections ≥ 3 was associated with reduced likelihood for eradication.

Conclusion

RFA was durable in maintaining dysplasia and IM eradication in both LSBE and ULSBE over 10 years, and with low complication rates. IM eradication was more difficult to achieve in ULSBE. Late development of cancer occurred in 14.3%.

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Title: Durability of radiofrequency ablation for long-segment and ultralong-segment Barrett’s esophagus over 10 years
Authors: Chu Luan Nguyen
David Tovmassian
Michael Zhou
Doruk Seyfi
Suzanna Gooley
Gregory L. Falk
Publication date: 13-12-2023
Publisher: Springer US
Keyword: Barrett Esophagus
Published in: Surgical Endoscopy / Issue 3/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10608-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Durability of radiofrequency ablation for long-segment and ultralong-segment Barrett’s esophagus over 10 years

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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