1004 Radiofrequency Ablation in Barrett's Esophagus With Confirmed Low-Grade Dysplasia: Interim Results of a European Multicenter Randomized Controlled Trial (SURF)

(EMR) prior to RFA, we stratified results by those treated with EMR/RFA versus RFA alone and performed comparative statistics using parametric tests. Results: Among 204 patients with IMC who were treated with RFA, 152 (75%) had one or more preceding EMRs. There were no deaths, perforations, or post-procedural bleeding after RFA; 11 patients (5.4%) experienced a treatment-related complication during 594 treatment sessions (1.8% of procedures), including 8 strictures (3.9%; 4.6% with EMR/RFA, 1.9% with RFA alone) and 3 hospitalizations (1.5%; all of whom underwent EMR/RFA). Rates of stricture, bleeding, and hospitalization were not clinically or statistically different (p.0.05) between patients treated with EMR/RFA and RFA alone. CEIM was achieved in 73% (72% EMR/RFA, 81% RFA alone) and CED was achieved in 89% (90% EMR/RFA, 85% RFA alone) over a mean of 2.6 ± 1.3 treatment sessions (see table 1). Efficacy rates were similar among those treated with EMR/RFA versus RFA alone (p.0.05) although fewer RFA treatment sessions were necessary if EMR was performed first (p=0.02). Six subjects required esophagectomy despite therapy. There was a trend toward higher rates of CEIM at academic centers (78%) as compared to community-based practices (61%) (p=0.05). Conclusions: In the largest reported series of patients with IMC, IM and dysplasia were eradicated in 73% and 89% of patients, respectively. Complications occurred in 5.4% of patients, with the majority being benign stricture (3.9%). Efficacy and safety rates were similar for EMR/RFA and RFA alone. RFA, with preceding EMR for nodular disease, is effective and safe treatment of intramucosal carcinoma; however close follow-up is required, since a small number of patients will require surgery for definitive therapy.