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Endoscopy 2010; 42(4): 272-278
DOI: 10.1055/s-0029-1243883
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Radiofrequency ablation of Barrett’s esophagus: outcomes of 429 patients from a multicenter community practice registry

W.  D.  Lyday1 , F.  S.  Corbett2 , D.  A.  Kuperman2 , I.  Kalvaria2 , P.  G.  Mavrelis3 , A.  B.  Shughoury3 , R.  E.  Pruitt4
  • 1The Center for GI Health, Cancer Prevention, Management and Nutritional Therapy, A Division of Atlanta Gastroenterology Associates, LLC, Atlanta, Atlanta, Georgia, USA
  • 2Sarasota Memorial Hospital, Sarasota, Florida, USA
  • 3St Mary’s Medical Center, Hobart, Indiana, USA
  • 4Maria Nathanson Center of Excellence at St Thomas Hospital, Nashville, Tennessee, USA
Further Information

Publication History

submitted 12 June 2009

accepted after revision 16 December 2009

Publication Date:
09 February 2010 (online)

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Commentaire de travail de W. D. Lyday et al., pp. 272Endoscopy 2010; 42(04): 350-350
DOI: 10.1055/s-0031-1291850

Background and study aims: The use of radiofrequency ablation (RFA) for complete eradication of Barrett’s esophagus has shown promise in trials conducted at predominantly tertiary academic centers; however less is known regarding outcomes in the community. We evaluated the safety and efficacy of RFA for Barrett’s esophagus delivered in a community practice setting.

Patients and methods: This was a multicenter registry conducted in community-based gastroenterology practices. Patients had confirmed intestinal metaplasia with or without dysplasia on biopsy of a Barrett’s esophagus. Intervention was step-wise RFA with follow-up esophageal biopsies. Endpoints were histology-based; complete response was defined as all biopsies at most recent endoscopy negative for intestinal metaplasia (CR-IM) or dysplasia (CR-D). Three cohorts were reported: 1) safety cohort, all patients; 2) efficacy cohort A, patients with at least one biopsy session after initial treatment; 3) efficacy cohort B, patients with at least one biopsy session ≥ 1 year after initial treatment.

Results: The safety cohort included 429 patients (71 % men, median age 59 years, median Barrett’s segment 3.0 cm). There were no serious adverse events (bleeding, perforation, death), and a stricture occurred after 1.1 % of cases (2.1 % of patients). In efficacy cohort A (n = 338), CR-IM and CR-D were achieved in 72 % and 89 % of patients, respectively (median follow-up 9 months). In efficacy cohort B (n = 137), CR-IM and CR-D were achieved in 77 % and 100 % of patients, respectively (median follow-up 20 months).

Conclusions: In this multicenter registry conducted at four community-based practices, the observed safety and efficacy outcomes associated with RFA for Barrett’s esophagus are comparable to those previously reported in multicenter trials from predominantly tertiary academic centers.

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