Early tumor formation in Barrett's esophagus (BE) can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.
"Barrett's esophagus is the most important risk factor for the development of esophageal cancer, but there is no generally accepted management strategy for patients with early neoplasia in Barrett's esophagus," said Jacques J.G. H. M. Bergman, MD, of the Academic Medical Center and lead author of the study. "Combining endoscopic resection with complete removal of residual Barrett cells with radiofrequency ablation may decrease the recurrence of lesion formation and could potentially limit the number of Barrett's esophagus cases that progress to esophageal cancer."
In this European multi-center, prospective cohort study, doctors evaluated the safety and efficacy of this combined modality approach in 23 BE patients with high-grade intraepithelial neoplasia (seven patients) or early cancer (16 patients). Eradication of tumors and abnormal intestinal cells was achieved in 95 percent and 88 percent of patients, and after additional escape endoscopic resection in two patients, in 100 percent and 96 percent of patients, respectively. Complications after RFA included melena (dark tarry stool) and difficulty swallowing. After additional follow-up, no neoplasia recurred.