Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett's oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry

Haidry, R. J.; Butt, M. A.; Dunn, J. M.; Gupta, A.; Lipman, G.; Smart, H. L.; Bhandari, P.; Smith, L.; Willert, R.; Fullarton, G.; Di Pietro, M.; Gordon, C.; Penman, I.; Barr, H.; Patel, P.; Kapoor, N.; Hoare, J.; Narayanasamy, R.; Ang, Y.; Veitch, A.; Raganuth, Krish; Novelli, M.; Lovat, L. B.

Abstract

Background Barrett's oesophagus (BE) is a pre-malignant condition leading to oesophageal adenocarcinoma (OAC). Treatment of neoplasia at an early stage is desirable. Combined endoscopic mucosal resection (EMR) followed by radiofrequency ablation (RFA) is an alternative to surgery for patients with BE-related neoplasia.

Methods We examined prospective data from the UK registry of patients undergoing RFA/EMR for BE-related neoplasia from 2008 to 2013. Before RFA, visible lesions were removed by EMR. Thereafter, patients had RFA 3-monthly until all BE was ablated or cancer developed (endpoints). End of treatment biopsies were recommended at around 12 months from first RFA treatment or when endpoints were reached. Outcomes for clearance of dysplasia (CR-D) and BE (CR-IM) at end of treatment were assessed over two time periods (2008–2010 and 2011–2013). Durability of successful treatment and progression to OAC were also evaluated.

Results 508 patients have completed treatment. CR-D and CR-IM improved significantly between the former and later time periods, from 77% and 56% to 92% and 83%, respectively (p

Citation

Haidry, R. J., Butt, M. A., Dunn, J. M., Gupta, A., Lipman, G., Smart, H. L., Bhandari, P., Smith, L., Willert, R., Fullarton, G., Di Pietro, M., Gordon, C., Penman, I., Barr, H., Patel, P., Kapoor, N., Hoare, J., Narayanasamy, R., Ang, Y., Veitch, A., …Lovat, L. B. (2015). Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett's oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry. Gut, 64(8), 1192-1199. https://doi.org/10.1136/gutjnl-2014-308501

• Journal Article Type: Article
• Acceptance Date: Nov 29, 2014
• Online Publication Date: Dec 24, 2014
• Publication Date: 2015-08
• Deposit Date: Feb 12, 2018
• Publicly Available Date: Oct 8, 2020
• Journal: Gut
• Print ISSN: 0017-5749
• Electronic ISSN: 1468-3288
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: 8
• Pages: 1192-1199
• DOI: https://doi.org/10.1136/gutjnl-2014-308501
• Public URL: https://nottingham-repository.worktribe.com/output/1118277
• Publisher URL: https://gut.bmj.com/content/64/8/1192
• PMID: 25539672