Despite endoscopic eradication therapy being an effective and durable treatment for Barrett’s esophagus-related neoplasia, even after achieving initial successful eradication, these patients remain at risk of recurrence and require ongoing routine examinations. Failure of radiofrequency ablation and argon plasma coagulation is reported in 10–20% of cases.
HEADGINGS:
Barrett Esophagus; Endoscopy; Radiofrequency Ablation; Argon Plasma Coagulation; Fundoplication; Gastrectomy
| APC | RFA | p-value | |||
|---|---|---|---|---|---|
| n=21 (%) | n=31 (%) | ||||
| Intestinal metaplasia | |||||
| Before treatment | 20 (95.2) | 25(80.6) | <0.21 | ||
| After treatment | |||||
| Total initial eradication | 14 (66.6)* * Eradication with regression to carditis | 17 (54.8)* * Eradication with regression to carditis | <0.02 | ||
| Residual island | 6 (28.6)† † Treated with repeated APC | 8 (25.8)† † Treated with repeated APC | <0.02 | ||
| Reappearance during follow-up | 1 (5)† † Treated with repeated APC | 4 (12.9)† † Treated with repeated APC | >0.37 | ||
| Progression to LGD | 0 | 0 | |||
| Intestinal metaplasia with LGD | |||||
| Before treatment | 1 (4.8) | 6 (19.4) | >0.21 | ||
| After treatment | |||||
| Total initial eradication | 1 (100)* * Eradication with regression to carditis | 4 (66.6)* * Eradication with regression to carditis | >0.37 | ||
| Residual island of IM | 0 | 2‡ ‡ Submitted to endoscopic submucosal dissection. | 1.0 | ||
| Reappearance IM during follow-up | 1† † Treated with repeated APC | 1† † Treated with repeated APC | >0.4 | ||
| Reappearance LGD during follow-up | 0 | 0 | |||
| Progression to HGD during follow-up | 0 | 0 | |||
| Progression to adenocarcinoma | 0 | 1§ § Submitted to esophageal resection. | |||
