UCL  IRIS
Institutional Research Information Service
UCL Logo
Please report any queries concerning the funding data grouped in the sections named "Externally Awarded" or "Internally Disbursed" (shown on the profile page) to your Research Finance Administrator. Your can find your Research Finance Administrator at https://www.ucl.ac.uk/finance/research/rs-contacts.php by entering your department
Please report any queries concerning the student data shown on the profile page to:

Email: portico-services@ucl.ac.uk

Help Desk: http://www.ucl.ac.uk/ras/portico/helpdesk
Publication Detail
Radiofrequency ablation compared with argon plasma coagulation after endoscopic resection of high-grade dysplasia or stage T1 adenocarcinoma in Barrett’s esophagus: a randomized pilot study (BRIDE)
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Peerally MF, Bhandari P, Ragunath K, Barr H, Haidry R, Lovat L, Smart H, Harrison R, Stokes C, Smith K, Morris T, de Caestecker JS
  • Publication date:
    01/04/2019
  • Journal:
    Gastrointest Endosc
  • Status:
    Published online
  • Country:
    United States
  • PII:
    S0016-5107(18)32898-0
  • Language:
    eng
  • Keywords:
    APC, Argon Plasma Coagulation, Barrett’s esophagus, Endoscopic resection, HGD, RFA, Radiofrequency ablation, ablation, esophageal adenocarcinoma, high grade dysplasia
Abstract
BACKGROUND AND AIMS: Endoscopic resection (ER) is safe and effective for Barrett's esophagus (BE) containing high-grade dysplasia (HGD) or mucosal adenocarcinoma (T1A); risk of metachronous neoplasia is reduced by ablation of residual BE using radiofrequency ablation (RFA) or argon plasma coagulation (APC). These have not been directly compared. We aimed to recruit up to 100 patients with BE and HGD or T1A confirmed by ER over 1 year in 6 centres in a randomized pilot study. METHODS: Randomization was 1:1 to RFA or APC (4 treatments allowed at 2 month intervals); recruitment, retention, dysplasia clearance, clearance of benign BE, adverse events, healthcare costs, and quality of life (QoL) using EQ-5D, EORTC QLQ-C30, OES18 were assessed up to the end of the trial at 12 months. RESULTS: Of 171 patients screened, 76 were randomized to RFA (n=36) or APC (n=40); mean age was 69.7, 82% male. BE was <5 cm (n=27), 5 to 10 cm (n=45), and >10 cm (n=4). Sixty-five patients completed the trial. At 12 months, dysplasia clearance was RFA 79.4% and APC 83.8% (OR, 0.7; 95% CI, 0.2-2.6); BE clearance was RFA 55.8%, and APC 48.3% (OR, 1.4; 95% CI, 0.5-3.6). A total of 6.1% (RFA) and 13.3% (APC) had buried BE glands. Adverse events (including stricture rate after starting RFA 3/36 [8.3%] and APC 3/37 [8.1%]) and QoL scores were similar, but RFA cost £21,147 more per case than APC. CONCLUSION: This pilot suggests similar efficacy and safety but a cost difference favoring APC. A fully powered non-inferiority trial is appropriate to confirm these findings.
Publication data is maintained in RPS. Visit https://rps.ucl.ac.uk
 More search options
UCL Researchers
Author
Department of Targeted Intervention
University College London - Gower Street - London - WC1E 6BT Tel:+44 (0)20 7679 2000

© UCL 1999–2011

Search by