title: Outcomes from a prospective trial of endoscopic radiofrequency ablation of early squamous cell neoplasia of the esophagus.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is safe and effective for eradicating neoplasia in Barrett's esophagus.
  
  
  OBJECTIVE
  To evaluate RFA for eradicating early esophageal squamous cell neoplasia (ESCN) defined as moderate-grade squamous intraepithelial neoplasia (MGIN) and high-grade squamous intraepithelial neoplasia (HGIN) and early flat-type esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Esophageal unstained lesions (USLs) were identified using Lugol's chromoendoscopy. Inclusion criteria were at least 1 flat (type 0-IIb) USL 3 cm or larger, USL-bearing esophagus 12 cm or less, and a consensus diagnosis of MGIN, HGIN, or ESCC by 2 expert GI pathologists. Exclusion criteria were previous endoscopic resection or ablation, stricture, or any nonflat mucosa.
  
  
  METHODS
  Circumferential RFA creating a continuous treatment area (TA) including all USLs. At 3-month intervals thereafter, chromoendoscopy with biopsies followed by focal RFA of USLs, if present.
  
  
  METHODS
  Complete response (CR) at 12 months defined as absence of MGIN, HGIN, or ESCC in the TA, CR after 1 RFA session, neoplastic progression from baseline, and adverse events.
  
  
  RESULTS
  Twenty-nine patients (14 male, mean age 60.3 years) with MGIN (n = 18), HGIN (n = 10), or ESCC (n = 1) participated. Mean USL length was 6.2 cm (TA 8.2 cm). At 3 months after 1 RFA session, 86% of patients (25/29) had a CR. At 12 months, 97% of patients (28/29) had a CR. There was no neoplastic progression. There were 4 strictures, all dilated to resolution.
  
  
  CONCLUSIONS
  Single-center study with limited number of patients.
  
  
  CONCLUSIONS
  In patients with early ESCN (MGIN, HGIN, flat-type ESCC), RFA was associated with a high rate of histological complete response (97% of patients), no neoplastic progression, and an acceptable adverse event profile.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, the Netherlands.
authors.forename: Jacques J G H M
authors.initials: JJ
authors.lastname: Bergman
authors.forename: Yue-Ming
authors.initials: YM
authors.lastname: Zhang
authors.forename: Shun
authors.initials: S
authors.lastname: He
authors.forename: Bas
authors.initials: B
authors.lastname: Weusten
authors.forename: Liyan
authors.initials: L
authors.lastname: Xue
authors.forename: David E
authors.initials: DE
authors.lastname: Fleischer
authors.forename: Ning
authors.initials: N
authors.lastname: Lu
authors.forename: Sanford M
authors.initials: SM
authors.lastname: Dawsey
authors.forename: Gui-Qi
authors.initials: GQ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D004311:Double-Blind Method; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome; D014741:Video Recording