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New Endoscopic Treatment May Spare Patients With Barrett’s Oesophagus From Surgery BETHESDA, Md -- February 18, 2010 -- Early tumour formation in Barrett’s oesophagus can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a study published in the journal Clinical Gastroenterology and Hepatology. “Barrett’s oesophagus is the most important risk factor for the development of oesophageal cancer, but there is no generally accepted management strategy for patients with early neoplasia in Barrett’s oesophagus,” said lead author Jacques Bergman, MD, Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands. “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 oesophagus cases that progress to oesophageal cancer.” In the European multicentre, prospective cohort study, researchers evaluated the safety and efficacy of this combined modality approach in 23 patients with Barrett’s oesophagus with high-grade intraepithelial neoplasia (n = 7) or early cancer (n = 16). Eradication of tumours and abnormal intestinal cells was achieved in 95% and 88% of patients, and after additional escape endoscopic resection in 2 patients, in 100% and 96% of patients, respectively. Complications after RFA included melena and difficulty swallowing. After additional follow-up, no neoplasia recurred. “Selection of Barrett’s oesophagus patients for endoscopic treatment involves thorough endoscopic work-up, the possibility to safely perform endoscopic resection, and accurate histological evaluation of tissue specimens for the presence of risk factors for disease spread,” added Dr. Bergman. “Patients in our study received care in highly specialised centres, making it difficult to extrapolate the high reported safety and effectives to all medical centres. We believe the use of radiofrequency ablation for Barrett’s oesophagus should be centralised in multi-disciplinary centres with this expertise.” SOURCE: American Gastroenterological Association E-mail this page to a friend or colleague! To print, use this version