Featured Research

from universities, journals, and other organizations

Treatment helps reduce risk of esophagus disorder progressing to cancer

Date:
March 25, 2014
Source:
The JAMA Network Journals
Summary:
Among patients with the condition known as Barrett's esophagus, treatment of abnormal cells with radiofrequency ablation (use of heat applied through an endoscope to destroy cells) resulted in a reduced risk of this condition progressing to cancer, according to a study. In the last 3 decades, the incidence of esophageal cancer has increased more rapidly that other cancers in the Western world. This type of cancer often originates from Barrett esophagus, a condition that involves abnormal changes in the cells of the lower portion of the esophagus, a complication of severe chronic gastrointestinal reflux disease.

Among patients with the condition known as Barrett esophagus, treatment of abnormal cells with radiofrequency ablation (use of heat applied through an endoscope to destroy cells) resulted in a reduced risk of this condition progressing to cancer, according to a study in the March 26 issue of JAMA.

In the last 3 decades, the incidence of esophageal cancer has increased more rapidly that other cancers in the Western world. This type of cancer often originates from Barrett esophagus, a condition that involves abnormal changes in the cells of the lower portion of the esophagus, a complication of severe chronic gastrointestinal reflux disease (GERD), according to background information in the article. Radiofrequency ablation (RFA) is an effective treatment for Barrett esophagus, but its benefits have largely been shown in patients with high-grade dysplasia (precancerous changes more likely to progress quickly to cancer). The question of whether RFA is effective for patients with Barrett esophagus and low-grade dysplasia (precancerous changes that progress more slowly to cancer) "is a clinically important question because 25 percent to 40 percent of patients with Barrett esophagus are diagnosed with low-grade dysplasia at some point during follow-up," the authors write.

K. Nadine Phoa, M.D., of the University of Amsterdam, the Netherlands, and colleagues randomly assigned 136 patients with a confirmed diagnosis of Barrett esophagus and low-grade dysplasia to radiofrequency ablation (ablation; maximum of 5 sessions allowed) or endoscopic surveillance (control). The researchers assessed the rate of progression to high-grade dysplasia and esophageal cancer. The study was conducted at 9 European sites between June 2007 and June 2011; follow-up ended May 2013.

The researchers found that ablation was associated with reduced absolute risk of progression to high-grade dysplasia or cancer of 25 percent (1.5 percent vs 26.5 percent for control) and a reduced absolute risk of progression to cancer of 7.4 percent (1.5 percent vs 8.8 percent). Complete eradication of dysplasia occurred and persisted in the majority of patients in the ablation group.

The trial was terminated early due to the superiority of ablation for the primary outcome and concerns about patient safety should the trial continue.

"In this multicenter, randomized trial of radiofrequency ablation vs surveillance in patients with Barrett esophagus and a confirmed histological diagnosis of low-grade dysplasia, ablation substantially reduced [tumor] progression to high-grade dysplasia and adenocarcinoma over 3 years of follow-up. Patients with a confirmed diagnosis of low-grade dysplasia should therefore be considered for ablation therapy," the authors conclude.

Editorial: Radiofrequency Ablation for Barrett Esophagus With Confirmed Low-Grade Dysplasia

Klaus Monkemuller, M.D., Ph.D., F.A.S.G.E., of the University of Alabama at Birmingham, comments on the findings of this study in an accompanying editorial.

"The clinical trial by Phoa et al provides important evidence to support the use of radiofrequency ablation not only for patients with high-grade dysplasia and early cancer, but also for carefully selected patients [via screening and testing] with Barrett esophagus and confirmed low-grade dysplasia. A proactive endoscopic approach to eliminate dysplasia may result in reduced morbidity and mortality related to the progression of this disease."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal References:

  1. K. Nadine Phoa, Frederike G. I. van Vilsteren, Bas L. A. M. Weusten, Raf Bisschops, Erik J. Schoon, Krish Ragunath, Grant Fullarton, Massimiliano Di Pietro, Narayanasamy Ravi, Mike Visser, G. Johan Offerhaus, Cees A. Seldenrijk, Sybren L. Meijer, Fiebo J. W. ten Kate, Jan G. P. Tijssen, Jacques J. G. H. M. Bergman. Radiofrequency Ablation vs Endoscopic Surveillance for Patients With Barrett Esophagus and Low-Grade Dysplasia. JAMA, 2014; 311 (12): 1209 DOI: 10.1001/jama.2014.2511
  2. Klaus Mφnkemόller. Radiofrequency Ablation for Barrett Esophagus With Confirmed Low-Grade Dysplasia. JAMA, 2014; 311 (12): 1205 DOI: 10.1001/jama.2014.2512

Cite This Page:

The JAMA Network Journals. "Treatment helps reduce risk of esophagus disorder progressing to cancer." ScienceDaily. ScienceDaily, 25 March 2014. <www.sciencedaily.com/releases/2014/03/140325164431.htm>.
The JAMA Network Journals. (2014, March 25). Treatment helps reduce risk of esophagus disorder progressing to cancer. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2014/03/140325164431.htm
The JAMA Network Journals. "Treatment helps reduce risk of esophagus disorder progressing to cancer." ScienceDaily. www.sciencedaily.com/releases/2014/03/140325164431.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) — Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) — Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) — At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) — The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:  

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile iPhone Android Web
      Follow Facebook Twitter Google+
      Subscribe RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins