Original ResearchFull Report: Clinical—Alimentary TractIncidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett’s Esophagus
Section snippets
US Radiofrequency Ablation Patient Registry
The US RFA Patient Registry is a multicenter study reporting processes and outcomes of care after treatment with RFA for BE at 148 institutions (113 community-based, 35 academic-affiliated). The registry was developed as a research tool to assess clinical outcomes after RFA using the HALO Ablation Systems (Covidien, GI Solutions, Sunnyvale, CA), and was funded by Covidien. The registry did not mandate protocols for care, but provided a suggested protocol for treatment and follow-up of patients
Results
Of 5521 patients who enrolled in the US RFA Patient Registry, 4982 (90%) met inclusion criteria. The remaining 539 (10%) did not undergo a biopsy session following initial treatment, and therefore were not at risk for a cancer diagnosis. These subjects were excluded from the risk analysis. The subjects were predominantly white (95%), male (74%), and had a mean age of 62 years (Table 1). At presentation, the mean BE segment was 4.1 cm, and 2346 (47%) patients had NDBE, 368 (7%) had IND, 1020
Discussion
Alhough the relationship of BE and EAC is well established, the impact of endoscopic therapy for BE on EAC incidence and mortality is not well described. Given that these therapies are performed in an effort to decrease death from cancer, such data are vital. The US RFA Registry was designed to assess rates of EAC incidence and EAC-specific and overall death in a large, primarily community practice-based cohort. In this largest reported cohort of patients treated with RFA for BE, the rate of
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Conflicts of interest N.J.S. has received research funding from Covidien Medical, CSA Medical, NeoGenomics, Takeda Pharmaceuticals, Interpace Diagnostics, and CDx Medical and is a consultant for Oncoscope. G.T., V.R.M., G.W.C., F.S.C., D.S.C., C.J.L., H.W., K.J.C., B.F.O., R.E.P., A.E., S.K., A.I., and R.I.R. have received research funding from Covidien Medical. W.A.W. has received funding to attend educational events sponsored by Nestlé. The other authors have no conflicts to declare.
Funding This research was funded by National Institutes of Health grants T32 DK07634 and P30 DK034987 and by GI Solutions, a subsidiary of Covidien.