Authors' recommendations: The only published randomised controlled trial of radiofrequency ablation (RFA) for Barrett's oesophagus with dysplasia compared RFA with sham treatment. RFA achieved higher rates of eradication of intestinal metaplasia (77% versus 2%) and high grade dysplasia (HGD) (81% versus 19%) at 12 month follow up. Observational data from the RCT extension study indicate treatment effect durability and a low rate of disease progression up to 3 years after RFA. Evidence from the RCT and case series indicates that the risk of major complications and adverse events from RFA is low. Two distinct economic models, each examining a different set of comparators, were identified: A NICE economic model studied patients with Barrett's oesophagus with HGD or early intramucosal cancer, comparing a range of interventions alone or in combination, compared with no surveillance. The cost/quality adjusted life year (QALY) of endoscopic mucosal resection, followed by RFA and surveillance versus no surveillance was £15,916. The cost/QALY of oesophagectomy versus no surveillance was £10,612. In another UK economic model in a hypothetical population of male patients with Barrett's oesophagus with HGD aged 64 years, RFA followed by surveillance dominated oesophagectomy (ie cost less and generated more QALYs).

Project Status: Completed

Year Published: 2012

URL for published report: http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_45.aspx

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Technologies Group

Contact Address: Scottish Health Technologies Group, Delta House, 50 West Nile Street, Glasgow, G1 2NP Tel: 0141 225 6998

Contact Name: his.shtg@nhs.scot

Contact Email: his.shtg@nhs.scot

Copyright: Healthcare Improvement Scotland