Barrett's Esophagus Information for Clinicians at BÂRRX Medical

DIGESTIVE DISEASE WEEK 2008: Summary of Presented Abstracts

Click on the image for access to the data presented at DDW 2008.

Click on the image for access to the DDW 2008 Schedule of Accepted Abstracts.

DDW 2008 included 17 scientific presentations related to the use of RFA for Barrett’s esophagus, the most prominent of which were:

AGA Clinical Plenary Session: Nick Shaheen, M.D. presented the interim results of the AIM Dysplasia Trial; a randomized sham-controlled trial of RFA vs. Sham for patients with Barrett’s containing low-grade or high-grade dysplasia.

RFA demonstrated strong superiority for complete response in both LGD and HGD groups for dysplasia and IM eradication.
RFA significantly reduced the progression rate to higher grades of dysplasia or carcinoma, as compared to the sham intervention.
Buried glandular mucosa was a common finding at baseline in this patient population, and was significantly reduced in the RFA group at 12 months, as compared to sham.

SSAT Presidential Plenary Session: Jacques J. Bergman, M.D., Ph.D. presented outcomes from the Academic Medical Centre in Amsterdam for treating advanced Barrett’s neoplasia and early cancer with combined endoscopic resection and RFA, resulting in a 97% complete eradication rate for dysplasia and IM and 100% avoidance of surgical intervention.

European multi-center trial (EURO-I Trial): After combined modality ER plus RFA for advanced Barrett’s neoplasia and early cancer, investigators reported that 96% of patients showed no evidence of dysplasia or IM at 1 year follow-up. They concluded that the safety and efficacy outcomes compare favorably to esophagectomy, APC, and PDT.

AIM Dysplasia Trial: Sub-analysis of pathology specimens from the AIM Dysplasia RCT, comparing the histological depth achieved on endoscopic biopsies at 12 months after RFA versus those obtained from the sham control group. After controlling for type of epithelium biopsied (glandular versus squamous), biopsies from RFA patients were as likely to demonstrate sub-epithelium as biopsies from the sham control group. The investigators concluded that endoscopic esophageal biopsies after RFA are of adequate depth to assess for sub-squamous glandular mucosa.

RFA vs. PDT for Barrett’s containing HGD: Two-center review of 225 patients treated with RFA (103) or PDT (122). RFA was associated with significantly fewer stricture complications as compared to PDT. Response rates for dysplasia were similar. The investigators concluded that these results may impact choice of ablation technique in patients with BE.

Genetic alterations before and after RFA: Biopsy fragments before and after successful RFA in 15 LGD patients (complete IM and dysplasia eradication) were assessed with a broad panel of 16 allelic imbalance (loss of heterozygosity [LOH]) mutational markers affecting 1p, 3p, 5q, 9p, 10q, 17p, 17q, 21q, 22q using quantitative fluorescent PCR / capillary electrophoresis. While all patients demonstrated multiple mutational markers at baseline, all had complete absence of these markers after RFA (up to 2.5 year follow-up).