In the Journals

Low recurrence of Barrett's esophagus observed after radiofrequency ablation

The majority of patients treated with radiofrequency ablation for Barrett’s esophagus did not experience recurrence, and specific predictors were identified for those who did in a recent study.

Nicholas J. Shaheen

Of 3,728 BE patients who achieved CEIM and had one or more post-CEIM biopsies at least 1 year after RFA, 85% achieved CEIM and 52% had one or more additional biopsies and could therefore be evaluated for recurrence (mean age, 61.7 years, 74% men, 93% white). Average follow-up was 2.4 years after CEIM.

Recurrence of BE was observed in 334 patients (20%), and was histologically classified as nondysplastic or indefinite for dysplasia in 287 (86%). Recurrence was more likely to occur in older patients (P=.003), those with longer BE segments (P<.0001), nonwhite patients (P=.03), those with dysplastic BE before RFA (P=.03), and patients who required more RFA sessions (P=.004), compared with patients without recurrence.

“Reversion to squamous epithelium after radiofrequency ablation for Barrett’s esophagus is durable in most patients,” Shaheen told Healio.com. “When intestinal metaplasia does recur in these patients, it is usually at a less severe histology than the initial Barrett’s. Patients with recurrent disease were more likely to be older, non-Caucasian, and have longer BE segments than those who did not recur.”

Disclosure: See the study for a full list of relevant financial disclosures.

The majority of patients treated with radiofrequency ablation for Barrett’s esophagus did not experience recurrence, and specific predictors were identified for those who did in a recent study.

To determine rates and predictors of Barrett’s esophagus (BE) recurrence after complete eradication of intestinal metaplasia (CEIM) after radiofrequency ablation (RFA), Nicholas J. Shaheen, MD, MPH, division of gastroenterology and hepatology, University of North Carolina School of Medicine, and colleagues conducted a nationwide multicenter study of patients, using 2007-2011 U.S. RFA Registry records.

Nicholas J. Shaheen

Of 3,728 BE patients who achieved CEIM and had one or more post-CEIM biopsies at least 1 year after RFA, 85% achieved CEIM and 52% had one or more additional biopsies and could therefore be evaluated for recurrence (mean age, 61.7 years, 74% men, 93% white). Average follow-up was 2.4 years after CEIM.

Recurrence of BE was observed in 334 patients (20%), and was histologically classified as nondysplastic or indefinite for dysplasia in 287 (86%). Recurrence was more likely to occur in older patients (P=.003), those with longer BE segments (P<.0001), nonwhite patients (P=.03), those with dysplastic BE before RFA (P=.03), and patients who required more RFA sessions (P=.004), compared with patients without recurrence.

“Reversion to squamous epithelium after radiofrequency ablation for Barrett’s esophagus is durable in most patients,” Shaheen told Healio.com. “When intestinal metaplasia does recur in these patients, it is usually at a less severe histology than the initial Barrett’s. Patients with recurrent disease were more likely to be older, non-Caucasian, and have longer BE segments than those who did not recur.”

Disclosure: See the study for a full list of relevant financial disclosures.