title: Outcomes of Radiofrequency Ablation for Dysplastic Barrett's Esophagus: A Comprehensive Review.
abstract: Barrett's esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett's esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett's esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett's esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett's esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett's esophagus using radiofrequency ablation.
authors.affiliation: Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, Italy.
authors.forename: Carmelo
authors.identifier: 0000-0001-5719-3948
authors.initials: C
authors.lastname: Luigiano
authors.affiliation: Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iabichino
authors.affiliation: HPB Endoscopy, Royal Free Hospital, London, UK; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
authors.forename: Leonardo Henry
authors.identifier: 0000-0003-3323-7744
authors.initials: LH
authors.lastname: Eusebi
authors.affiliation: Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Arena
authors.affiliation: Department of Medicine and Pharmacology, University of Messina, Hospital "G. Martino", Via Consolare Valeria, 98124 Messina, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Consolo
authors.affiliation: Department of Medicine and Pharmacology, University of Messina, Hospital "G. Martino", Via Consolare Valeria, 98124 Messina, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Morace
authors.affiliation: Department of Surgery, Unit of Hepatobilyopancreatic and Digestive Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, No. 8, 20142 Milano, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Opocher
authors.affiliation: Unit of Digestive Endoscopy, Istituto Clinico Humanitas Mater Domini, Via Gerenzano 2, 21053 Castellanza, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Mangiavillano