Evidence map›Paper›PMID 40661999›Full record

ReviewCureus2025

Efficacy and Safety of Advanced Endoscopic Techniques in Early Barrett's Neoplasia: A Systematic Review and Pooled Analysis.

Neelam Khetpal, Saeed Ali, Sana Hussain, Asad Ali, Mohamad Sharbatji, Christopher Childs, Muhammad Ali Khan, Muhammad K Hasan

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Neelam KhetpalGastroenterology and Hepatology, Cleveland Clinic Florida, Weston, USA.
Saeed AliInternal Medicine, AdventHealth/Florida Hospital, Orlando, USA.
Sana HussainInternal Medicine, AdventHealth/Florida Hospital, Orlando, USA.
Asad AliGastroenterology and Hepatology, SUNY Upstate Medical University, Syracuse, USA.
Mohamad SharbatjiInternal Medicine, AdventHealth/Florida Hospital, Orlando, USA.
Christopher ChildsHardin Library for the Health Sciences, University of Iowa, Iowa City, USA.
Muhammad Ali KhanGastroenterology and Hepatology, University of Texas MD Anderson Cancer Center, Houston, USA.
Muhammad K HasanGastroenterology, Center for Interventional Endoscopy, AdventHealth Orlando, Orlando, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Focal endoscopic mucosal resection (f-EMR) followed by radiofrequency ablation (f-EMR+RFA), stepwise/complete EMR (c-EMR), and endoscopic submucosal dissection (ESD) are used to manage Barrett's esophagus (BE)-related high-grade dysplasia (HGD) and early adenocarcinoma (EAC). We present a systematic review and meta-analysis evaluating these modalities' cumulative and comparative efficacy and safety. We evaluated studies reporting efficacy and safety of ESD, f-EMR+RFA, and c-EMR for BE-related early neoplasia management. Primary outcomes were recurrence of HGD or EAC and risk of strictures, perforation, and bleeding. Secondary outcomes were en bloc and R0 resections for ESD and complete eradication of neoplasia for f-EMR-RFA and c-EMR. Thirty-eight studies with 2,434 patients (684 ESD, 938 f-EMR+RFA, 812 c-EMR) were included. Weighted pooled rates (WPR) for recurrence were 10.3% (ESD), 5% (f-EMR+RFA), and 7.4% (c-EMR). There was no difference in recurrence with any endoscopic modality (p>0.05). WPR for strictures was 9.5% (ESD), 11.5% (f-EMR+RFA), and 29% (c-EMR). ESD and f-EMR+RFA were associated with lower stricture formation compared to c-EMR (p<0.05), while there was no difference seen between ESD and f-EMR+RFA. WPR for perforation was 3.7% (ESD), 1.6% (f-EMR+RFA), and 2% (c-EMR). F-EMR+RFA was associated with a lower risk of perforation compared to ESD (p=0.01), while no difference was found between ESD and c-EMR. WPR for bleeding was 3.5% (ESD), 3% (f-EMR+RFA), and 6% (c-EMR). There was no difference in the recurrence of neoplasia with any endoscopic modality. f-EMR+RFA appears to be the preferred endoscopic modality for the management of BE-related neoplasia.

Indexed as

barrett’s esophagus-related high-grade dysplasiaearly adenocarcinomaendoscopic submucosal dissectionfocal endoscopic mucosal resection followed by radiofrequency ablationstepwise/complete emr

Identifiers

PMID40661999
PMCPMC12258868

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Registered trials

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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.