Navigation Links
Treatment helps reduce risk of esophagus disorder progressing to cancer
Date:3/25/2014

Among patients with the condition known as Barrett esophagus, treatment of abnormal cells with radiofrequency ablation (use of heat applied through an endoscope to destroy cells) resulted in a reduced risk of this condition progressing to cancer, according to a study in the March 26 issue of JAMA.

In the last 3 decades, the incidence of esophageal cancer has increased more rapidly that other cancers in the Western world. This type of cancer often originates from Barrett esophagus, a condition that involves abnormal changes in the cells of the lower portion of the esophagus, a complication of severe chronic gastrointestinal reflux disease (GERD), according to background information in the article. Radiofrequency ablation (RFA) is an effective treatment for Barrett esophagus, but its benefits have largely been shown in patients with high-grade dysplasia (precancerous changes more likely to progress quickly to cancer). The question of whether RFA is effective for patients with Barrett esophagus and low-grade dysplasia (precancerous changes that progress more slowly to cancer) "is a clinically important question because 25 percent to 40 percent of patients with Barrett esophagus are diagnosed with low-grade dysplasia at some point during follow-up," the authors write.

K. Nadine Phoa, M.D., of the University of Amsterdam, the Netherlands, and colleagues randomly assigned 136 patients with a confirmed diagnosis of Barrett esophagus and low-grade dysplasia to radiofrequency ablation (ablation; maximum of 5 sessions allowed) or endoscopic surveillance (control). The researchers assessed the rate of progression to high-grade dysplasia and esophageal cancer. The study was conducted at 9 European sites between June 2007 and June 2011; follow-up ended May 2013.

The researchers found that ablation was associated with reduced absolute risk of progression to high-grade dysplasia or cancer of 25 percent (1.5 percent vs 26.5 percent for control) and a reduced absolute risk of progression to cancer of 7.4 percent (1.5 percent vs 8.8 percent). Complete eradication of dysplasia occurred and persisted in the majority of patients in the ablation group.

The trial was terminated early due to the superiority of ablation for the primary outcome and concerns about patient safety should the trial continue.

"In this multicenter, randomized trial of radiofrequency ablation vs surveillance in patients with Barrett esophagus and a confirmed histological diagnosis of low-grade dysplasia, ablation substantially reduced [tumor] progression to high-grade dysplasia and adenocarcinoma over 3 years of follow-up. Patients with a confirmed diagnosis of low-grade dysplasia should therefore be considered for ablation therapy," the authors conclude.

(doi:10.1001/jama.2014.2511; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Radiofrequency Ablation for Barrett Esophagus With Confirmed Low-Grade Dysplasia

Klaus Monkemuller, M.D., Ph.D., F.A.S.G.E., of the University of Alabama at Birmingham, comments on the findings of this study in an accompanying editorial.

"The clinical trial by Phoa et al provides important evidence to support the use of radiofrequency ablation not only for patients with high-grade dysplasia and early cancer, but also for carefully selected patients [via screening and testing] with Barrett esophagus and confirmed low-grade dysplasia. A proactive endoscopic approach to eliminate dysplasia may result in reduced morbidity and mortality related to the progression of this disease."

(doi:10.1001/jama.2014.2512; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.


'/>"/>

Contact: Jacques J. Bergman, M.D., Ph.D.
j.j.bergman@amc.uva.nl
The JAMA Network Journals
Source:Eurekalert

Related medicine news :

1. Researchers issue state-of-the-state on genetic-based testing and treatment for breast cancer
2. Twenty-five percent of breast cancer survivors report financial decline due to treatment
3. Einstein helps establish $28 million consortium to find ebola treatment
4. Chemo-free treatment a possibility for leukemia/lymphoma
5. Sepsis study comparing 3 treatment methods shows same survival rate
6. Dartmouth researchers develop new approach to chronic lymphocytic leukemia treatment
7. Gene variants protect against relapse after treatment for hepatitis C
8. PSA-testing and early treatment decreases risk of prostate cancer death
9. Emerging multi-drug resistant infections lack standard definition and treatment
10. Making treatment of rare blood disorder more affordable and effective
11. Discoveries point to more powerful cancer treatments, fewer side effects
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... , ... Conventional wisdom preaches the benefits of moderation, whether it’s a matter ... bar too high can result in disappointment, perhaps even self-loathing. However, those who set ... , Research from PsychTests.com reveals that behind the tendency to set low ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was ... his family verbally and physically. , “When something upset him, he couldn’t control his emotions,” ... He would throw rocks at my other children and say he was going to kill ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, ... and the Road To Recovery® program to drive cancer patients to and from their ... to ensure the highest quality of life and ongoing independence. Getting to and ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... proud to recognize Dr. Barry M. Weintraub as a prominent plastic surgeon and ... women in the world, and the most handsome men, look naturally attractive. Plastic ...
(Date:6/24/2016)... ... , ... Venture Construction Group (VCG) sponsors Luke’s Wings ... the Woodmont Country Club at 1201 Rockville Pike, Rockville, Maryland, 20852. The event ... that have been wounded in battle and their families. Venture Construction Group is a ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... MEDIA, Pa. , June 23, 2016 ... treatments in an outpatient dialysis facility.  Treatments are usually ... to 6 hours per visit, including travel time, equipment ... on a patient, but especially grueling for patients who ... residents of a skilled nursing and rehabilitation centers for ...
(Date:6/23/2016)... NEW YORK , June 23, 2016 ... rough waters, but it continues to present great opportunities ... featured companies for today: Intrexon Corp. (NYSE: ... ), Arena Pharmaceuticals Inc. (NASDAQ: ARNA ), ... Learn more about these stocks and receive your complimentary ...
(Date:6/23/2016)... , June 23, 2016  Delcath Systems, Inc. ... medical device company focused on treatment of primary and ... for European patient education - www.againsttheodds.eu - ... Biannual Digital Health Awards. The ... for European patients and their families who are coping ...
Breaking Medicine Technology: