Short-Term Impact of Radiofrequency Ablation on Esophageal Functional Quality of Life in Patients With Barrett's Neoplasia

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology Pub Date : 2025-03-05 DOI:10.1111/jgh.16917

Naeman Goetz, Kimberley Ryan, Katherine Hanigan, Lee Jones, Matthew Remedios, Florian Grimpen

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引用次数: 0

Abstract

Background and Aim

Endoscopic treatment is accepted as mainstream therapy to treat dysplastic Barrett's esophagus (BO) or early esophageal adenocarcinoma (OAC) to prevent disease progression. Radiofrequency ablation (RFA) is widely used for treating flat, noncancerous Barrett's mucosa but may cause significant short-term pain and dysphagia. This study aimed to assess the short-term impact of RFA on esophageal functional quality of life (QOL), compared to surveillance endoscopy.

Methods

This prospective, observational study was conducted at a tertiary hospital in Brisbane, Australia, and enrolled consecutive patients undergoing surveillance or RFA for BO between June 2020 and March 2023. Participants completed the European Organisation for Research and Treatment of Cancer's esophageal symptom questionnaire (EORTC-QLQ-OES18) immediately before and 1 week after each procedure. Tweedie models in a General Estimating Equation framework were used to account for nonnormally distributed data.

Results

A total of 533 procedures were performed on 136 patients, with 451 included in the analysis. Of these, 302 were surveillance, and 149 were RFA procedures. Patients' median age was 65, and 83% were male. At follow-up, RFA patients reported significantly worse QOL compared to surveillance patients, particularly in dysphagia (25.1 vs. 9.5), eating difficulties (26.3 vs. 12.5), and pain (23.0 vs. 9.5), all with p < 0.001. No differences were found in dry mouth or speech issues.

Conclusion

RFA treatment for dysplastic BO can have a substantial short-term negative impact on QOL, especially concerning dysphagia, eating, and pain and difficulties swallowing saliva, highlighting the need for thorough patient counseling before treatment.

查看原文本刊更多论文

射频消融对巴雷特肿瘤患者食管功能生活质量的短期影响。

背景与目的：内镜治疗是治疗发育不良的巴雷特食管（BO）或早期食管腺癌（OAC）以预防疾病进展的主流治疗方法。射频消融术（RFA）广泛用于治疗平坦的非癌性巴雷特粘膜，但可能引起明显的短期疼痛和吞咽困难。本研究旨在评估RFA对食管功能生活质量（QOL）的短期影响，并与内窥镜检查进行比较。方法：这项前瞻性观察性研究在澳大利亚布里斯班的一家三级医院进行，招募了2020年6月至2023年3月期间连续接受BO监测或RFA的患者。参与者在每次手术前和手术后一周完成欧洲癌症研究和治疗组织食道症状问卷（EORTC-QLQ-OES18）。使用一般估计方程框架中的Tweedie模型来解释非正态分布的数据。结果：136例患者共行533例手术，其中451例纳入分析。其中，302项为监测，149项为RFA程序。患者中位年龄为65岁，83%为男性。在随访中，RFA患者报告的生活质量明显低于监测患者，特别是在吞咽困难（25.1比9.5）、进食困难（26.3比12.5）和疼痛（23.0比9.5）方面，均为p。结论：RFA治疗发育不良BO可对生活质量产生实质性的短期负面影响，特别是在吞咽困难、进食、疼痛和吞咽唾液困难方面，强调需要在治疗前对患者进行彻底的咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.