title: Endoscopic radiofrequency ablation for early esophageal squamous cell neoplasia: report of safety and effectiveness from a large prospective trial.
abstract: OBJECTIVE
  Endoscopic radiofrequency ablation (RFA) is an established therapy for Barrett's esophagus. Preliminary reports, limited by low patient numbers, also suggest a possible role for RFA in early esophageal squamous cell neoplasia (ESCN). The aim of this study was to evaluate the safety and effectiveness of RFA for early ESCN (moderate/high grade intraepithelial neoplasia [MGIN/HGIN] and early flat-type esophageal squamous cell carcinoma [ESCC]).
  
  
  METHODS
  This prospective cohort study included patients with at least one flat (type 0-IIb) unstained lesion (USL) on Lugol's chromoendoscopy and a consensus diagnosis of MGIN, HGIN, or early ESCC. RFA was used at baseline to treat all USLs, and then biopsy (and focal RFA if USL persisted) was performed every 3 months until all biopsies were negative for MGIN, HGIN, and ESCC. The main outcome measurements were complete response at 3 and 12 months (absence of MGIN, HGIN, and ESCC), neoplastic progression, and adverse events.
  
  
  RESULTS
  A total of 96 patients participated (MGIN 45, HGIN 42, early ESCC 9). At 3 and 12 months, 73 % (70/96) and 84 % (81/96), respectively, showed a complete response. Two patients (2 %) progressed (MGIN to HGIN; HGIN to T1m2 ESCC); both were treated endoscopically and achieved complete response. Stricture occurred in 20 patients (21 %), all after circumferential RFA. Lugol's + RFA 12 J/cm(2) (single application, no cleaning) was the favored baseline circumferential RFA technique (82 % 12-month complete response [14/17], 6 % stricture [6/17]).
  
  
  CONCLUSIONS
  In patients with early ESCN, RFA was associated with a high complete response rate and an acceptable safety profile.
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Shun
authors: S
authors: He
authors: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Jacques
authors: J
authors: Bergman
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Yueming
authors: Y
authors: Zhang
authors: Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Bas
authors: B
authors: Weusten
authors: Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Liyan
authors: L
authors: Xue
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Xiumin
authors: X
authors: Qin
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Lizhou
authors: L
authors: Dou
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Yong
authors: Y
authors: Liu
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, United States.
authors: David
authors: D
authors: Fleischer
authors: Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Ning
authors: N
authors: Lu
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States.
authors: Sanford M
authors: SM
authors: Dawsey
authors: Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
authors: Gui-Qi
authors: GQ
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D004396:Coloring Agents; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007454:Iodides; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011446:Prospective Studies; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy; D017211:Treatment Failure
chemical_list: D004396:Coloring Agents; D007454:Iodides; C010389:Lugol's solution