This new study showed that radiofrequency ablation, a form of heat treatment, can slow the progression of Barrett’s esophagus, a condition in which the cells of the lower esophagus are damaged, increasing the risk of cancer.
The researchers found that using ablation therapy also greatly lowered the risk of cancer in patients with Barrett’s esophagus.
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This study was led by K. Nadine Phoa, MD, of the University of Amsterdam, the Netherlands.
This research team randomly assigned 136 patients diagnosed with Barrett’s esophagus and low-grade dysplasia to radiofrequency ablation, a procedure in which heat is applied to the target cells to destroy them through an endoscope, or endoscopic surveillance only.
Dysplasia is a precancerous condition in which cells are very similar to cancer cells. An endoscope is a small camera that can be inserted through the mouth, in this case, to see images of the affected areas of the esophagus.
Barrett’s esophagus is a condition in which the lower esophagus, the muscular tube that runs from the back of the mouth to the stomach, is damaged by acid from the stomach. The repeated contact with stomach acid begins to change the cells of the lower esophagus, which leads to a greater risk of esophageal cancer.
The participants of this study were selected from nine European sites from June 2007 to June 2011, with the follow-up exams concluding in May 2013.
The researchers assessed the progression of low-grade dysplasia, in which less than 50 percent of the cells had begun to change, to high-grade dysplasia, in which more than 50 percent of the cells had begun to change.
The research team found that radiofrequency ablation reduced the risk of progressing to high-grade dysplasia or cancer by 25 percent. Only 1.5 percent of patients who received radiofrequency ablation progressed to high-grade dysplasia or cancer, compared with 26.5 percent of those who received other treatments.
The data showed that the ablation treatment lowered the overall progression rate to cancer by 7.4 percent, with 1.5 percent of ablation-treated patients progressing to a cancer diagnosis, compared with 8.8 percent of the patients who received other treatments.
The authors noted that this trial was terminated early due to the success of ablation in improving the outcome for patients being treated for Barrett’s esophagus.
Dr. Phoa and team concluded that radiofrequency ablation has been shown to greatly reduce the risk of Barrett’s esophagus becoming worse or progressing to cancer. Patients diagnosed with Barrett’s esophagus should be considered for radiofrequency ablation therapy, according to these authors.
The authors acknowledged that this study was limited by the exclusive use of expert referral centers and may not reflect the outcomes elsewhere.
This study was published March 25 in the Journal of the American Medical Association (JAMA).
This study was funded in part by Covidien GI Solutions (formerly BÂRRX Medical) and by the Maag Lever Darm Stichting grant.
Raf Bisschops, MD, and other authors of this study reported receiving grants from the Fund for Scientific Research Flanders and other organizations.