title: Detection of intestinal metaplasia after successful eradication of Barrett's Esophagus with radiofrequency ablation.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is an effective means of eradicating Barrett's esophagus (BE), both with and without associated dysplasia. Several studies have documented high initial success rates with RFA. However, there is limited data on IM detection rates after eradication.
  
  
  OBJECTIVE
  To determine the rate of detection of intestinal metaplasia (IM) after successful eradication of Barrett's esophagus.
  
  
  METHODS
  BE patients with and without dysplasia who had undergone RFA were retrospectively identified. Only those who had complete eradication as documented on the initial post-ablation endoscopy, and had minimum two surveillance endoscopies, were included in the analyses. Clinical, demographic, and endoscopic data were collected. Cumulative incidence of IM detection was calculated by the Kaplan-Meier method.
  
  
  RESULTS
  Forty-seven patients underwent RFA and had complete eradication of Barrett's epithelium. The majority of patients were male (76.6%), and the mean age was 64.2 years. The cumulative incidence of newly detected IM at 1 year was 25.9% (95% CI 15.1-42.1%). Dysplasia was detected at the time of recurrence in four patients, and all cases were detected at the GE junction in the absence of visible BE. Patients with recurrent IM had longer baseline segments of BE (median, 4 cm vs. 2 cm, p = 0.03).
  
  
  CONCLUSIONS
  The rate of detection of new IM is high in patients who have undergone successful eradication of BE by RFA. Additionally, dysplasia can recur at the GE junction in the absence of visible BE. Future studies are warranted to identify those patients at increased risk for the development of recurrent intestinal metaplasia.
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, NY, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Vaccaro
authors.forename: Susana
authors.initials: S
authors.lastname: Gonzalez
authors.forename: John M
authors.initials: JM
authors.lastname: Poneros
authors.forename: Peter D
authors.initials: PD
authors.lastname: Stevens
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Capiak
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Lightdale
authors.forename: Julian A
authors.initials: JA
authors.lastname: Abrams
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology*; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome