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Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt jason dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman Marco Novelli Laurence B Lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia Oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation

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