ReviewCureus2025
Evaluating the Efficacy and Safety of Radiofrequency Ablation Compared to Endoscopic Surveillance in Managing Low-Grade Dysplasia in Barrett's Esophagus: A Systematic Review and Meta-Analysis.
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.
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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.
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.
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0 citing papers in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Barrett's esophagus with low-grade dysplasia (BE-LGD) risks progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC). Guidelines remain equivocal on managing non-nodular BE-LGD, endorsing either radiofrequency ablation (RFA) or endoscopic surveillance (ES). This systematic review compares RFA and ES in preventing progression to HGD/EAC to inform clinical practice.Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, MEDLINE, EMBASE, Web of Science, and Google Scholar were searched (September 2024) for randomized controlled trials (RCTs) comparing RFA and ES in BE-LGD. Outcomes included HGD/EAC progression, complete eradication of dysplasia (CE-D) and intestinal metaplasia (CE-IM), adverse events, and predictors of progression/response. Risk of bias (RoB) was assessed using Cochrane RoB 2. Meta-analysis used Mantel-Haenszel random-effects models.Four RCTs (n = 282) were included. The studies varied in follow-up duration and excluded patients with nodular BE-LGD. RFA was associated with reduced progression to HGD/EAC compared with ES (relative risk (RR) 0.23; 95% confidence interval (CI) 0.05-1.02; p = 0.05) and achieved higher CE-D and CE-IM both post-treatment (CE-D: RR 2.70; 95% CI 1.37-5.32; p = 0.004; CE-IM: RR 21.80; 95% CI 4.56-104.29; p < 0.0001) and durably (CE-D: RR 3.06; 95% CI 2.07-4.52; p < 0.00001; CE-IM: RR 61.60; 95% CI 8.66-438.21; p < 0.0001). Adverse events occurred only with RFA but were manageable. Single-study data reported that ES progression correlated with shorter Barrett's diagnosis time, more dysplasia-positive endoscopies, and longer circumferential Barrett's length. No significant predictors of RFA response emerged.In conclusion, RFA significantly reduces HGD/EAC progression in BE-LGD compared to ES, with superior CE-D/CE-IM rates and manageable adverse events, supporting its use as first-line therapy for non-nodular BE-LGD. Future studies should compare RFA to emerging therapies. The trials' restrictive eligibility criteria, variable center and operator expertise, differences in treatment protocols and ablation targets, and methodological issues-including early exclusions, cross-over, incomplete reporting, and potential conflicts of interest-limited generalizability and interpretation of long-term efficacy and safety.
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