Development of Subsquamous High-Grade Dysplasia and Adenocarcinoma After Successful Radiofrequency Ablation of Barrett's Esophagus

Patients with Barrett's esophagus are frequently treated with radiofrequency ablation (RFA). Those that undergo this procedure have a low risk of developing subsquamous intestinal metaplasia, and none have been reported to develop subsquamous dysplasia or cancer. We report the development of su...

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Published inGastroenterology (New York, N.Y. 1943) Vol. 143; no. 3; pp. 564 - 566.e1
Main Authors Titi, Mohammad, Overhiser, Andrew, Ulusarac, Ozlem, Falk, Gary W, Chak, Amitabh, Wang, Kenneth, Sharma, Prateek
Format Journal Article
LanguageEnglish
Published United States 01.09.2012
Subjects
Adenocarcinoma - pathology
Aged
Barrett Esophagus - pathology
Barrett Esophagus - surgery
Biopsy
Catheter Ablation
Disease Progression
Endoscopy, Gastrointestinal
Esophageal Neoplasms - pathology
Esophagus - pathology
Esophagus - surgery
Gastroenterology and Hepatology
Humans
Metaplasia
Middle Aged
Precancerous Conditions - pathology
Precancerous Conditions - surgery
Time Factors
Treatment Outcome
Therapy
Biopsy
Esophageal Adenocarcinoma
endoscopic mucosal resection
EMR
RFA
radiofrequency ablation
Cancer Risk
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Summary:Patients with Barrett's esophagus are frequently treated with radiofrequency ablation (RFA). Those that undergo this procedure have a low risk of developing subsquamous intestinal metaplasia, and none have been reported to develop subsquamous dysplasia or cancer. We report the development of subsquamous neoplasia in 3 patients who were treated with RFA for Barrett's esophagus (2 developed adenocarcinoma and 1 developed high-grade dysplasia). The identification of these cases indicates the need for continued surveillance following RFA, even after complete eradication of intestinal metaplasia, and caution for widespread use of ablation, especially in patients with low-risk Barrett's esophagus.
ISSN:0016-5085
1528-0012
DOI:10.1053/j.gastro.2012.04.051