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:6/23/2017)... ... , ... 21 Middle East and South Asia Leaders Selected as Eisenhower Fellows ... and civil society in 11 countries across the Middle East and South Asia to ... exchange of knowledge and ideas with the leading minds in their fields. , ...
(Date:6/23/2017)... (PRWEB) , ... June 23, 2017 , ... ... with Private Flood Insurance offerings. With the Federal Emergency Management Agency’s (FEMA) recent ... across the United States. In 2012, the Biggert-Waters Act was enacted to reflect ...
(Date:6/23/2017)... ... June 23, 2017 , ... The Katyl ... services to families and business owners in and around Lackawanna County, is joining ... citizens in the area. , Meals on Wheels of NEPA provides hand-delivered and ...
(Date:6/23/2017)... ... June 23, 2017 , ... ... personal financial planning to families and business owners in North Central West Virginia, ... help provide services to differently abled residents in the region. , The Stepping ...
(Date:6/22/2017)... ... June 22, 2017 , ... Plastic Surgery Associates is proud to report that ... Each year, research and information firm, Castle Connolly, releases their list of the most ... marks the 3rd time that Dr. Canales has been recognized by Castle ...
Breaking Medicine News(10 mins):
(Date:6/8/2017)... , June 8, 2017  StatLab ... leading developer and manufacturer of diagnostic supplies ... today that Cressey & Company LP ("Cressey ... has completed a growth-focused investment in the ... majority ownership position from selling shareholder, Prairie ...
(Date:6/5/2017)... 2017 The Cincinnati location ... Inc. (NYSE: DPLO), has been awarded a Top Workplaces ... Results are based on an employee survey administered by ... workplace improvement. The survey measures several aspects of workplace culture, ... ...
(Date:6/1/2017)... BLUE BELL, Pa. , June 1, 2017 /PRNewswire/ ... Nutriceuticals (PRN) and Veterinarian Recommended Solutions (VRS), and KD ... direct investment in Nutriceutical Holdings by KD Pharma Group. ... Nutriceutical Holdings with the option to acquire the entire ... ideal partner in KD. They are committed to growing ...
Breaking Medicine Technology: