Original ResearchFull Report: Clinical—Alimentary TractRadiofrequency Ablation and Endoscopic Mucosal Resection for Dysplastic Barrett's Esophagus and Early Esophageal Adenocarcinoma: Outcomes of the UK National Halo RFA Registry
Section snippets
Inclusion Criteria
All patients were referred for consideration of ablative management of dysplastic BE at a collaborating center. Only males and nonpregnant females older than 21 years of age with no contraindications to endoscopy were considered. All patients gave written informed consent and agreed to attend at regular intervals for treatment and surveillance procedures. Ethical approval was granted by the Joint UCL/UCLH Committee on the Ethics of Human Research (REC REF 08/H0714/27).
Pre-Enrollment Staging
All patients were
Registry Enrollment and Demographics
We report the outcomes of 335 patients who have completed the 1-year protocol in the registry from 19 centers nationwide between July 2008 and August 2012.
Demographic data are shown in Table 1. The mean length of BE segment ablated was 5.8 cm (range, 0−20 cm). Before ablation, the highest grade lesion was HGD in 72% of patients. Two of the centers had previous experience in PDT and therefore 26 (8%) patients had ablation after residual neoplasia after PDT. Nearly half the patients in the cohort
Discussion
This is the largest series to date of patients with early Barrett's neoplasia undergoing RFA. These data demonstrate the diverse baseline characteristics of the patients and the success of integrating novel minimally invasive endotherapy into everyday practice from 19 centers nationwide.
There is ongoing debate about the role of minimally invasive endotherapy in the treatment of patients with BE. There have been great improvements in laparoscopic esophagectomy and data on long-term durability
Acknowledgments
This work was undertaken at UCLH/UCL, which received a proportion of funding from the Department of Health's National Institute for Health Research Biomedical Research Centres funding scheme. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health. The work was also supported by the CRUK UCL Early Cancer Medicine Centre.
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Cited by (0)
Drs Lovat and Haidry had full access to all of the data and take full responsibility for the veracity of the data and statistical analysis.
Clinical Trials Registry: Ethical approval was granted by the Joint UCL/UCLH Committee on the ethics of Human research (REC REF 08/H0714/27).
Conflicts of interest This author discloses the following: L. B. Lovat has received grant support from BARRX Medical Inc and Covidien plc to support research infrastructure. Neither company has been involved in this research nor have they seen this manuscript before its submission. The remaining authors disclose no conflicts.