title: Development of subsquamous high-grade dysplasia and adenocarcinoma after successful radiofrequency ablation of Barrett's esophagus.
abstract: 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.
authors.affiliation: Veterans Affairs Medical Center, Kansas City, Missouri; University of Kansas School of Medicine, Kansas City, Kansas, Missouri.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Titi
authors.affiliation: Veterans Affairs Medical Center, Kansas City, Missouri; University of Kansas School of Medicine, Kansas City, Kansas, Missouri.
authors.forename: Andrew
authors.initials: A
authors.lastname: Overhiser
authors.affiliation: Veterans Affairs Medical Center, Kansas City, Missouri; University of Kansas School of Medicine, Kansas City, Kansas, Missouri.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ulusarac
authors.affiliation: University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Gary W
authors.initials: GW
authors.lastname: Falk
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chak
authors.affiliation: Mayo Graduate School of Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wang
authors.affiliation: Veterans Affairs Medical Center, Kansas City, Missouri; University of Kansas School of Medicine, Kansas City, Kansas, Missouri. Electronic address: psharma@kumc.edu.
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D017115:Catheter Ablation; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000473:pathology*; D004947:Esophagus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008679:Metaplasia; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome