Can you stop surveillance after radiofrequency ablation of Barrett's esophagus? A glass half full

Abstract

A large proportion of patients with dysplasia will have durable eradication of their dysplasia. Patients with dysplasia have a low but persistent risk of recurrent metaplasia and dysplasia; thus, ongoing surveillance is required until better predictors of risk are available to identify low-risk patients in whom surveillance may be decreased or discontinued. It is possible that the surveillance frequency may be decreased; more detailed data on time to recurrence are needed to inform guidelines. There is a moderate risk of recurrent metaplasia. Although the risk of this metaplasia is unclear, patients after ablation should be considered to be in remission, rather than cured. There is a critical need for comparative trials of surveillance and ablation, which evaluate solid outcomes such as the development of advanced cancer, need for surgery, and death from cancer. Comparative trials are also needed to evaluate different ablation treatment methods and different regimens of acid suppression. © 2013 by the AGA Institute.