Radiofrequency ablation for the treatment of Barrett's esophagus with high-grade and lowgrade dysplasia: an update
Almeida N, Dendukuri N
Record ID 32017000415
English
Authors' objectives:
The objectives of this report were to update the evidence presented in our previous
report on the effectiveness, durability, and safety of radiofrequency ablation for the
treatment of Barrett's esophagus with high grade dysplasia when compared with other
treatment modalities; to evaluate the evidence on the effectiveness, durability, and
safety of RFA treatment for low-grade dysplasia versus endoscopic surveillance; and to
update the cost and budget impact estimates associated with RFA use at the MUHC.
Authors' recommendations:
Radiofrequency ablation is now the standard of care for the treatment of
Barrett's patients with high grade dysplasia because there is good evidence for its
effectiveness and safety in eliminating dysplastic tissue, and because the
alternative treatment with esophagectomy is associated with higher morbidity.
Ablation therapy for LGD remains controversial because of the lack of data on
diagnostic accuracy, and uncertainty surrounding the progression rates from LGD
to cancer. Although recent evidence from two randomized controlled trials
suggest RFA is effective in treating LGD, uncertainties in diagnostic accuracy and
progression rates to cancer, and the spontaneous reversion of LGD in some
patients do not warrant routine treatment of LGD patients with endoscopic
ablation therapies.
Currently, the MUHC only treats patients with confirmed HGD with
radiofrequency ablation, and 38 HGD patients have been treated since 2010. Of
these, one patient required esophagectomy 5 years after diagnosis.
Details
Project Status:
Completed
Year Published:
2016
URL for published report:
http://www.mcgill.ca/tau/files/tau/muhc_tau_2016_79_barrett_esophagus_na_0.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Barrett Esophagus
- Catheter Ablation
- Esophageal Neoplasms
- Humans
Contact
Organisation Name:
Technology Assessment Unit of the McGill University Health Centre (MUHC)
Contact Address:
Technology Assessment Unit of the MUHC, Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, 5252 boul. de Maisonneuve, Bureau 3F.50, Montreal, Quebec H4A 3S5
Contact Name:
nandini.dendukuri@mcgill.ca
Contact Email:
nandini.dendukuri@mcgill.ca
Copyright:
Technology Assessment Unit of the McGill University Health Centre (MUHC)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.