Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett's oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial

Abstract

In patients with BO ≤ 5 cm containing HGD/EC, SRER and ER/RFA achieved comparably high rates of CR-IM and CR-neoplasia. However, SRER was associated with a higher number of complications and therapeutic sessions. For these patients, a combined endoscopic approach of focal ER followed by RFA may thus be preferred over SRER. Clinical trial number NTR1337.

Endoscopic diagnosis and therapies for Barrett esophagus: a review

“…The stenosis rate was significantly higher in CBE-EMR (88 % vs. 14 %; p < 0.001), resulting in more therapeutic sessions (6 vs. 3; p < 0.001) due to dilations (123).…”

“…3). Complete response from CBE-EMR in studies has ranged from 76 to 100 % and complete eradication of dysplasia in 86 % to 100 % of cases (93,(118)(119)(120)(121)(122)(123) (Table II).…”

“…The available data from prospective trials are summarized in Table III (123,(145)(146)(147)(148)(149)(150)(151)(152)(153)(154)(155)(156).…”

“…The balance of tissue acquisition and adverse effect profile for patients with dysplasia may be best achieved with a hybrid approach where EMR is used for all visible lesions and the remainder of the epithelium is treated with serial RfA which carries a more favorable complication profile (123,149,181,182).…”

Strategies to improve outcomes in esophageal adenocarcinoma

“…They provide complete removal of intestinal metaplasia in 96% and 92% of cases respectively. In a randomized controlled trial comparing SRER and EMR/RFA, by van Vilsteren and colleagues, SRER required a median of six sessions including dilatation for strictures in 88% of cases, whereas EMR/RFA has a median of three sessions and 14% stricture rate [54].…”