Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II)
| Autor: | Oliver Pech, Stefan Seewald, Helmut Messmann, Mike Visser, K. Nadine Phoa, Liebwin Gossner, Jacques J. Bergman, Alexander Meining, Roos E. Pouw, Horst Neuhaus, Christian Ell, Fiebo J.W. ten Kate, Toni Lerut, Krish Ragunath, Raf Bisschops, Erik J. Schoon, Bjorn Rembacken, Bas L. Weusten, Jayan Mannath, C A Seldenrijk, Brigitte Schumacher |
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| Přispěvatelé: | Gastroenterology and hepatology, VU University medical center, Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Imaging and biomarkers, CCA - Cancer Treatment and quality of life, Other departments, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA -Cancer Center Amsterdam |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Early cancer Adolescent Esophageal Neoplasms Radiofrequency ablation Biopsy medicine.medical_treatment Catheter ablation Kaplan-Meier Estimate law.invention Barrett Esophagus 03 medical and health sciences 0302 clinical medicine law Humans Medicine In patient Prospective Studies Prospective cohort study Adverse effect Aged Aged 80 and over medicine.diagnostic_test business.industry Gastroenterology Middle Aged medicine.disease ddc Surgery Europe Treatment Outcome surgical procedures operative Dysplasia 030220 oncology & carcinogenesis Catheter Ablation Female 030211 gastroenterology & hepatology Esophagoscopy business Precancerous Conditions |
| Zdroj: | Gut, 65(4), 555-62. BMJ Publishing Group Gut, 65(4), 555-562. BMJ Publishing Group Phoa, K N, Pouw, R E, Bisschops, R, Pech, O, Ragunath, K, Weusten, B L A M, Schumacher, B, Rembacken, B, Meining, A, Messmann, H, Schoon, E J, Gossner, L, Mannath, J, Seldenrijk, C A, Visser, M, Lerut, T, Seewald, S, ten Kate, F J, Ell, C, Neuhaus, H & Bergman, J J G H M 2016, ' Multimodality endoscopic eradication for neoplastic Barrett oesophagus : results of an European multicentre study (EURO-II) ', Gut, vol. 65, no. 4, pp. 555-62 . https://doi.org/10.1136/gutjnl-2015-309298 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gutjnl-2015-309298 |
| Popis: | OBJECTIVE: Focal endoscopic resection (ER) followed by radiofrequency ablation (RFA) safely and effectively eradicates Barrett's oesophagus (BO) containing high-grade dysplasia (HGD) and/or early cancer (EC) in smaller studies with limited follow-up. Herein, we report long-term outcomes of combined ER and RFA for BO (HGD and/or EC) from a single-arm multicentre interventional study.DESIGN: In 13 European centres, patients with BO ≤ 12 cm with HGD and/or EC on 2 separate endoscopies were eligible for inclusion. Visible lesions (OUTCOMES: complete eradication of neoplasia (CE-neo) and intestinal metaplasia (CE-IM); durability of CE-neo and CE-IM (once achieved) during follow-up. Biopsy and resection specimens underwent centralised pathology review.RESULTS: 132 patients with median BO length C3M6 were included. After entry-ER in 119 patients (90%) and a median of 3 RFA (IQR 3-4) treatments, CE-neo was achieved in 121/132 (92%) and CE-IM in 115/132 patients (87%), per intention-to-treat analysis. Per-protocol analysis, CE-neo and CE-IM were achieved in 98% and 93%, respectively. After a median of 27 months following the first negative post-treatment endoscopic control, neoplasia and IM recurred in 4% and 8%, respectively. Mild-to-moderate adverse events occurred in 25 patients (19%); all managed conservatively or endoscopically.CONCLUSIONS: In patients with early Barrett's neoplasia, intensive multimodality endotherapy consisting of ER combined with RFA is safe and highly effective, and the treatment effect appears to be durable during mid-term follow-up.TRIAL REGISTRATION NUMBER: NTR 1211, http://www.trialregister.nl. |
| Databáze: | OpenAIRE |
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