TY - JOUR
T1 - Outcomes from a prospective trial of endoscopic radiofrequency ablation of early squamous cell neoplasia of the esophagus
AU - Bergman, Jacques J.G.H.M.
AU - Zhang, Yue Ming
AU - He, Shun
AU - Weusten, Bas
AU - Xue, Liyan
AU - Fleischer, David E.
AU - Lu, Ning
AU - Dawsey, Sanford M.
AU - Wang, Gui Qi
N1 - Funding Information:
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Dr. Bergman: medical supplies for study purposes from BÄRRX Medical and urestricted grant from Olympus Medical ; Dr. Wang: medical supplies for study purposes from BÄRRX Medical. The other authors disclosed no financial relationships relevant to this publication. The study was supported in part by the Intramural Research Program of the NIH, National Cancer Institute, Division of Cancer Epidemiology and Genetics.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Radiofrequency ablation (RFA) is safe and effective for eradicating neoplasia in Barrett's esophagus. Objective: To evaluate RFA for eradicating early esophageal squamous cell neoplasia (ESCN) defined as moderate-grade squamous intraepithelial neoplasia (MGIN) and high-grade squamous intraepithelial neoplasia (HGIN) and early flat-type esophageal squamous cell carcinoma (ESCC). Design: Prospective cohort study. Setting: Tertiary referral center. Patients: Esophageal unstained lesions (USLs) were identified using Lugol's chromoendoscopy. Inclusion criteria were at least 1 flat (type 0-IIb) USL 3 cm or larger, USL-bearing esophagus 12 cm or less, and a consensus diagnosis of MGIN, HGIN, or ESCC by 2 expert GI pathologists. Exclusion criteria were previous endoscopic resection or ablation, stricture, or any nonflat mucosa. Interventions: Circumferential RFA creating a continuous treatment area (TA) including all USLs. At 3-month intervals thereafter, chromoendoscopy with biopsies followed by focal RFA of USLs, if present. Main Outcome Measurements: Complete response (CR) at 12 months defined as absence of MGIN, HGIN, or ESCC in the TA, CR after 1 RFA session, neoplastic progression from baseline, and adverse events. Results: Twenty-nine patients (14 male, mean age 60.3 years) with MGIN (n = 18), HGIN (n = 10), or ESCC (n = 1) participated. Mean USL length was 6.2 cm (TA 8.2 cm). At 3 months after 1 RFA session, 86% of patients (25/29) had a CR. At 12 months, 97% of patients (28/29) had a CR. There was no neoplastic progression. There were 4 strictures, all dilated to resolution. Limitations: Single-center study with limited number of patients. Conclusions: In patients with early ESCN (MGIN, HGIN, flat-type ESCC), RFA was associated with a high rate of histological complete response (97% of patients), no neoplastic progression, and an acceptable adverse event profile.
AB - Background: Radiofrequency ablation (RFA) is safe and effective for eradicating neoplasia in Barrett's esophagus. Objective: To evaluate RFA for eradicating early esophageal squamous cell neoplasia (ESCN) defined as moderate-grade squamous intraepithelial neoplasia (MGIN) and high-grade squamous intraepithelial neoplasia (HGIN) and early flat-type esophageal squamous cell carcinoma (ESCC). Design: Prospective cohort study. Setting: Tertiary referral center. Patients: Esophageal unstained lesions (USLs) were identified using Lugol's chromoendoscopy. Inclusion criteria were at least 1 flat (type 0-IIb) USL 3 cm or larger, USL-bearing esophagus 12 cm or less, and a consensus diagnosis of MGIN, HGIN, or ESCC by 2 expert GI pathologists. Exclusion criteria were previous endoscopic resection or ablation, stricture, or any nonflat mucosa. Interventions: Circumferential RFA creating a continuous treatment area (TA) including all USLs. At 3-month intervals thereafter, chromoendoscopy with biopsies followed by focal RFA of USLs, if present. Main Outcome Measurements: Complete response (CR) at 12 months defined as absence of MGIN, HGIN, or ESCC in the TA, CR after 1 RFA session, neoplastic progression from baseline, and adverse events. Results: Twenty-nine patients (14 male, mean age 60.3 years) with MGIN (n = 18), HGIN (n = 10), or ESCC (n = 1) participated. Mean USL length was 6.2 cm (TA 8.2 cm). At 3 months after 1 RFA session, 86% of patients (25/29) had a CR. At 12 months, 97% of patients (28/29) had a CR. There was no neoplastic progression. There were 4 strictures, all dilated to resolution. Limitations: Single-center study with limited number of patients. Conclusions: In patients with early ESCN (MGIN, HGIN, flat-type ESCC), RFA was associated with a high rate of histological complete response (97% of patients), no neoplastic progression, and an acceptable adverse event profile.
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U2 - 10.1016/j.gie.2011.05.024
DO - 10.1016/j.gie.2011.05.024
M3 - Article
C2 - 21839994
AN - SCOPUS:82755160909
SN - 0016-5107
VL - 74
SP - 1181
EP - 1190
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 6
ER -