Endoscopic radiofrequency ablation or surveillance in patients with Barrett’s oesophagus with confirmed low-grade dysplasia: a multicentre randomised trial
| Autor: | Jean Escourrou, Frédéric Prat, Romain Legros, Nadira Kaddour, Edouard Chabrun, Marc Le Rhun, Michael Bensoussan, Hendy Abdoul, Frank Zerbib, Thierry Ponchon, Maximilien Barret, E Metivier-Cesbron, Stanislas Chaussade, Gabriel Rahmi, Fabrice Caillol, P. Bauret, Lea Jilet, Geoffroy Vanbiervliet, Jérémie Jacques, Marc Giovannini, Julien Branche, Benoit Terris, Mathieu Pioche, René Laugier, Christian Boustière, Franck Cholet, Emmanuel Coron, Sarah Leblanc |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Hospitals Low-Volume Time Factors Esophageal Neoplasms Radiofrequency ablation Adenocarcinoma Endoscopy Gastrointestinal law.invention Barrett Esophagus law medicine Humans In patient Prospective Studies Watchful Waiting Trial registration Aged Radiofrequency Ablation business.industry Gastroenterology Intestinal metaplasia Middle Aged medicine.disease Endoscopic ablation Surgery Low grade dysplasia Treatment Outcome Dysplasia Barrett's oesophagus Disease Progression Female business Hospitals High-Volume |
| Zdroj: | Gut. 70:1014-1022 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gutjnl-2020-322082 |
| Popis: | ObjectiveDue to an annual progression rate of Barrett’s oesophagus (BO) with low-grade dysplasia (LGD) between 9% and 13% per year endoscopic ablation therapy is preferred to surveillance. Since this recommendation is based on only one randomised trial, we aimed at checking these results by another multicentre randomised trial with a similar design.DesignA prospective randomised study was performed in 14 centres comparing radiofrequency ablation (RFA) (maximum of 4 sessions) to annual endoscopic surveillance, including patients with a confirmed diagnosis of BO with LGD. Primary outcome was the prevalence of LGD at 3 years. Secondary outcomes were the prevalence of LGD at 1 year, the complete eradication of intestinal metaplasia (CE-IM) at 3 years, the rate of neoplastic progression at 3 years and the treatment-related morbidity.Results125 patients were initially included, of whom 82 with confirmed LGD (76 men, mean age 62.3 years) were finally randomised, 40 patients in the RFA and 42 in the surveillance group. At 3 years, CE-IM rates were 35% vs 0% in the RFA and surveillance groups, respectively (pConclusionRFA modestly reduced the prevalence of LGD as well as progression risk at 3 years. The risk-benefit balance of endoscopic ablation therapy should therefore be carefully weighted against surveillance in patients with BO with confirmed LGD.Trial registration numberNCT01360541. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|