Gender Differences in Remission of Esophageal Intestinal Metaplasia after Radiofrequency Ablation

Qumseya, Bashar J.; David, Waseem; McCrum, Marta L.; Dong, Yan; Raimondo, Massimo; Woodward, Timothy A.; Wallace, Michael B.; Wolfsen, Herbert C.

doi:10.1038/ajg.2013.454

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…However, most of these studies are restricted by small numbers of minority patients and females, and are therefore limited in their ability to assess for sex and race differences in disease patterns. Previous studies of ablation therapy for BE also have had similar shortcomings with respect to numbers of females and minorities (7, 8, 20–22)…”

Section: Introductionmentioning

confidence: 99%

Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett’s esophagus: results from the U.S. RFA Registry

Pasricha

Bulsiewicz

et al. 2015

Gastrointestinal Endoscopy

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Background Little is known about differences in Barrett’s esophagus (BE) characteristics by sex, and race/ethnicity, or these differences in response to radiofrequency ablation (RFA). Objective We compared disease-specific characteristics, treatment efficacy, and safety outcomes by sex and race/ethnicity in patients treated with RFA for BE. Design and Setting The U.S. RFA Patient Registry is a multicenter collaboration reporting processes and outcomes of care for patients treated with RFA for BE. Patients and Interventions Patients with BE treated with RFA. Main outcome measurements We assessed safety (stricture, bleeding, perforation, hospitalization), efficacy (complete eradication of intestinal-metaplasia (CEIM)), complete eradication of dysplasia, and number of treatments to CEIM by sex and race/ethnicity. Results Among 5521 patients (4052 males; 5126 Caucasian, 137 Hispanic, 82 African-American, 40 Asian, 136 not identified), females were younger (60.0 vs. 62.1 yrs.), had shorter BE (3.2 vs. 4.4 cm), and less dysplasia (37% vs. 57%) than males. Females were almost twice as likely to stricture (OR 1.7; 95% CI, 1.2–2.3). Although Caucasians were predominantly male, about half of African-Americans and Asians with BE were females. African-Americans and Asians had less dysplasia than Caucasians. Asians and African-Americans had more strictures than Caucasians. There were no sex or race differences in efficacy. Limitations Observational study with non-mandated paradigms, no central lab for re-interpretation of pathology Conclusions In the U.S. RFA Registry, females had shorter BE and less aggressive histology. The usual male sex predilection for BE was absent in African-Americans and Asians. Post-treatment stricture was more common among females, and Asians. RFA efficacy did not differ by sex or race.

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Section: Introductionmentioning

confidence: 99%

Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett’s esophagus: results from the U.S. RFA Registry

Pasricha

Bulsiewicz

et al. 2015

Gastrointestinal Endoscopy

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“…The median time to CRIM after the start of treatment was 13.4 months (95% CI, 10.3-17.7 months) for EMR-RFA patients, 20.4 months (95% CI, 16.6-25.8 months) for RFA patients, and 6.7 months (95% CI, 5.7-8.6 months) for Ps-PDT patients. The cumulative incidence of CRIM at 12 months after starting treatment was 71.9% for Ps-PDT, 22.9% for RFA, and 47.8% for EMR-RFA group (Fig. 2).…”

Section: Complete Response To Treatmentmentioning

confidence: 93%

“…Upper endoscopy was also performed to detect mucosal abnormalities for mucosal resection. 22,23 Unfortunately, we did not prospectively record standardized descriptions of these mucosal irregularities by using criteria such as the Paris classification. At our institution, we require secondary review by an experienced GI pathologist for tissue samples demonstrating dysplasia or neoplasia.…”

Section: Standard Protocolmentioning

confidence: 99%

Comparison of endoscopic treatment modalities for Barrett’s neoplasia

David

Qumseya

Qumsiyeh

et al. 2015

Gastrointestinal Endoscopy

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“…4 Male predisposition to BE and EAC has long been established but has been understood poorly. 5 We know that men and women have different esophageal protective mechanisms. For instance, there appears to be a difference in mRNA expression of protective genes.…”

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confidence: 99%

Endoscopic therapy for Barrett’s esophagus: our experience beyond white men

Qumseya

Wolfsen

2015

Gastrointestinal Endoscopy

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Gender Differences in Remission of Esophageal Intestinal Metaplasia after Radiofrequency Ablation

Abstract: Females take longer time to achieve CRIM when treated with RFA when compared with males of similar age and BE length.

Cited by 5 publications

References 25 publications

Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett’s esophagus: results from the U.S. RFA Registry

Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett’s esophagus: results from the U.S. RFA Registry

Comparison of endoscopic treatment modalities for Barrett’s neoplasia

Endoscopic therapy for Barrett’s esophagus: our experience beyond white men

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