Evidence map›Paper›PMID 29524114›Full record

ArticleDigestive diseases and sciences2018

Cryotherapy and Radiofrequency Ablation for Eradication of Barrett's Esophagus with Dysplasia or Intramucosal Cancer.

Prashanthi N Thota, Zubin Arora, John A Dumot, Gary Falk, Tanmayee Benjamin, John Goldblum, Sunguk Jang, Rocio Lopez, John J Vargo

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Prashanthi N ThotaCenter of Excellence for Barrett's Esophagus, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA. thotap@ccf.org.
Zubin AroraCenter of Excellence for Barrett's Esophagus, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
John A DumotDepartment of Gastroenterology and Hepatology, Case Western Reserve University, Cleveland, OH, 44106, USA.
Gary FalkDepartment of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.
Tanmayee BenjaminCenter of Excellence for Barrett's Esophagus, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
John GoldblumDepartment of Pathology, Cleveland Clinic, Cleveland, OH, 44195, USA.
Sunguk JangCenter of Excellence for Barrett's Esophagus, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Rocio LopezDepartment of Biostatistics, Cleveland Clinic, Cleveland, OH, 44195, USA.
John J VargoCenter of Excellence for Barrett's Esophagus, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Cleveland Clinic · USCase Western Reserve University · USHospital of the University of Pennsylvania · US

Funding

Whole Exome Approaches for Esophageal Adenocarcinoma Susceptibility GenesU54CA163060 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI CHAK, AMITABH, GUDA, KISHORE · 2011 to 2022
$14.0M
NCI NIH HHS U54 CA163060
6 · The paper itself

Abstract

BACKGROUND AND

aimsEndoscopic ablation therapy has become the mainstay of treatment of Barrett's associated dysplasia and intramucosal cancer (IMC). The widely available techniques for ablation are radiofrequency ablation (RFA) and cryotherapy. Our aim was to compare eradication rates of metaplasia and dysplasia with both these modalities. PATIENTS AND

methodsRetrospective review of prospectively collected database of patients who underwent endoscopic therapy for Barrett's dysplasia or IMC from 2006 to 2011 was performed. Demographic features, comorbidities, and endoscopic data including length of Barrett's segment, hiatal hernia size, interventions during the endoscopy and histological results were reviewed.

resultsAmong 154 patients included, 73 patients were in the RFA and 81 patients were in the cryotherapy group. There was complete eradication of intestinal metaplasia (CE-IM) in 81 (52.6%), complete eradication of dysplasia (CE-D) in 133 (86.4%), and persistent dysplasia or cancer in 19 patients (12.3%). Compared to RFA, cryotherapy patients were found to be older and less likely to have undergone endoscopic mucosal resection. On multivariate analysis, patients who underwent RFA had a threefold higher odds of having CE-IM than those who underwent cryotherapy (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.4-6.0, p = 0.004), but CE-D were similar between the two groups (OR 1.7, 95% CI 0.66-4.3, p = 0.28).

conclusionsEndoscopic therapy is highly effective in eradication of Barrett's associated neoplasia. Patients who underwent cryotherapy were equally likely to achieve CE-D but not CE-IM than patients who underwent RFA. Patient characteristics and preferences may effect choice of treatment selection and outcomes.

Indexed as

Catheter AblationCryosurgeryAdultAgedAged, 80 and overBarrett EsophagusCarcinoma in SituEndoscopic Mucosal ResectionEsophageal NeoplasmsEsophagoscopyFemaleFollow-Up StudiesHumansLogistic ModelsMaleMiddle AgedAblationBarrett’s esophagusCryotherapyDysplasiaEndoscopy

Identifiers

PMID29524114
PMCPMC7053567
OpenAlexW2791194792

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.