Department of Surgery and TransplantationRigshospitaletCopenhagen University Hospital, Copenhagen ØDenmark.
Department of Surgery and Transplantation, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Scand J Surg. 2023 Jun;112(2):86-90. doi: 10.1177/14574969231151378. Epub 2023 Feb 8.
Barrett's esophagus (BE) is associated with an increased risk of esophageal adenocarcinoma. The use of radio frequency ablation (RFA) for complete eradication of BE with confirmed low-grade dysplasia (LGD) or high-grade dysplasia (HGD) has been promising in multicenter trials. Our aim was to evaluate the safety and efficacy outcomes associated with RFA for patients with BE and LGD/HGD in a single-center setting.
This was a retrospective single-center study conducted at Department of Surgery and Transplantation, Rigshospitalet, Denmark. Data were collected from all patients who had undergone RFA for LGD or HGD from January 2014 to December 2018. Effectiveness outcomes were based on histology: complete eradication of dysplasia (CE-D), defined as all esophageal biopsies being negative for dysplasia at the last biopsy session, and complete eradication of intestinal metaplasia (CE-IM) defined as esophageal biopsies being without intestinal metaplasia. Safety outcomes were based on the proportion of complications to the RFA treatment.
A total of 107 patients were identified during the follow-up period (75% men, median age = 65 years); 83% had LGD and 17% had HGD. The median follow-up was 25 months. After the last RFA treatment, CE-D was achieved in 89%. CE-D and CE-IM were achieved in 60%. Complications occurred in 6.5% of the patients.
In patients with BE and confirmed LGD or HGD, RFA was associated with a high rate of CE-D and a low risk of complications. The observed safety and efficacy outcomes were comparable with those previously reported in multicenter trials, showing that the Danish treatment of BE with LGD and HGD is comparable with those of larger European expert centers.
巴雷特食管（BE）与食管腺癌风险增加相关。在多中心试验中，射频消融（RFA）用于完全消除伴有低级别异型增生（LGD）或高级别异型增生（HGD）的 BE 已显示出良好的效果。我们的目的是评估在单中心环境下 RFA 治疗 BE 伴 LGD/HGD 患者的安全性和疗效。
这是一项在丹麦 Rigshospitalet 外科和移植科进行的回顾性单中心研究。该研究的数据来自于所有于 2014 年 1 月至 2018 年 12 月期间接受 RFA 治疗 LGD 或 HGD 的患者。疗效结果基于组织学：完全消除异型增生（CE-D），定义为最后一次活检中所有食管活检均无异型增生；完全消除肠上皮化生（CE-IM），定义为食管活检无肠上皮化生。安全性结果基于 RFA 治疗的并发症比例。
在随访期间共发现 107 例患者（75%为男性，中位年龄为 65 岁）；83%为 LGD，17%为 HGD。中位随访时间为 25 个月。末次 RFA 治疗后，89%达到 CE-D。CE-D 和 CE-IM 的达到率为 60%。6.5%的患者出现并发症。
在 BE 伴确诊 LGD 或 HGD 的患者中，RFA 与高 CE-D 率和低并发症风险相关。观察到的安全性和疗效结果与多中心试验中报道的结果相似，表明丹麦治疗 LGD 和 HGD 的 BE 与更大的欧洲专家中心相当。
