title: Radiofrequency ablation is effective for the treatment of high-grade dysplasia in Barrett's esophagus after failed photodynamic therapy.
abstract: Endoscopic radiofrequency ablation (RFA) is an effective treatment for high-grade dysplasia in Barrett's esophagus in ablation-naïve patients, but no studies have evaluated its use in patients in whom ablative therapy has previously failed. We describe 14 patients with residual high-grade dysplasia following aminolevulinic acid or Photofrin (porfimer sodium) photodynamic therapy (PDT). An overall complete reversal of dysplasia was achieved in 86 % with a combination of RFA and rescue endoscopic mucosal resection. The median total follow-up is 19 months. The rate of strictures was 7 % (1/14) and there was a low rate of buried glands (0.5 % follow-up biopsies). These data suggest RFA is both safe and effective for eradication of high-grade dysplasia in patients in whom PDT has failed.
authors: National Medical Laser Centre, Department of Surgery, University College London, London, UK.
authors: J M
authors: JM
authors: Dunn
authors: M R
authors: MR
authors: Banks
authors: D
authors: D
authors: Oukrif
authors: G D
authors: GD
authors: Mackenzie
authors: S
authors: S
authors: Thorpe
authors: M
authors: M
authors: Rodriguez-Justo
authors: A
authors: A
authors: Winstanley
authors: S G
authors: SG
authors: Bown
authors: M R
authors: MR
authors: Novelli
authors: L B
authors: LB
authors: Lovat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome