Sarina Pasricha1, Nan Li1, William J Bulsiewicz1, Richard I Rothstein2, Anthony Infantolino3, Atilla Ertan4, Daniel S Camara5, Evan S Dellon1, George Triadafilopoulos6, Charles J Lightdale7, Ryan D Madanick1, William D Lyday8, Raman V Muthusamy9, Bergein F Overholt10, Nicholas J Shaheen1. 1. Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 2. Dartmouth University School of Medicine, Hanover, New Hampshire, USA. 3. Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA. 4. University of Texas School of Medicine, Houston, Texas, USA. 5. Digestive Health Physicians, Cheektowaga, New York, USA. 6. Stanford University School of Medicine, Palo Alto, California, USA. 7. Columbia University School of Medicine, New York, New York, USA. 8. Atlanta Gastroenterology Associates, Atlanta, Georgia, USA. 9. UCLA School of Medicine, Los Angeles, California, USA. 10. Gastrointestinal Associates, Knoxville, Tennessee, USA.
Abstract
BACKGROUND: Little is known about differences in Barrett's esophagus (BE) characteristics by sex and race and/or ethnicity or these differences in response to radiofrequency ablation (RFA). OBJECTIVE: We compared disease-specific characteristics, treatment efficacy, and safety outcomes by sex and race and/or ethnicity in patients treated with RFA for BE. DESIGN: The U.S. RFA patient registry is a multicenter collaboration reporting processes and outcomes of care for patients treated with RFA for BE. PATIENTS: Patients enrolled with BE. INTERVENTIONS: RFA. MAIN OUTCOME MEASUREMENTS: We assessed safety (stricture, bleeding, perforation, hospitalization), efficacy (complete eradication of intestinal metaplasia [CEIM]), complete eradication of dysplasia, and number of treatments to CEIM by sex and race and/or ethnicity. RESULTS: Among 5521 patients (4052 men; 5126 white, 137 Hispanic, 82 African American, 40 Asian, 136 heritage not identified), women were younger (60.0 vs 62.1 years) and had shorter BE segments (3.2 vs 4.4 cm) and less dysplasia (37% vs 57%) than did men. Women were almost twice as likely to stricture (odds ratio 1.7; 95% confidence interval, 1.2-2.3). Although white patients were predominantly male, about half of African Americans and Asians with BE were female. African Americans and Asians had less dysplasia than white patients. Asians and African Americans had more strictures than did white patients. There were no sex or race differences in efficacy. LIMITATIONS: Observational study with non-mandated paradigms, no central laboratory for reinterpretation of pathology. CONCLUSION: In the U.S. RFA patient registry, women had shorter BE segments and less-aggressive histology. The usual tendency toward BE in men was absent in African Americans and Asians. Posttreatment stricture was more common among women and Asians. RFA efficacy did not differ by sex or race.
BACKGROUND: Little is known about differences in Barrett's esophagus (BE) characteristics by sex and race and/or ethnicity or these differences in response to radiofrequency ablation (RFA). OBJECTIVE: We compared disease-specific characteristics, treatment efficacy, and safety outcomes by sex and race and/or ethnicity in patients treated with RFA for BE. DESIGN: The U.S. RFA patient registry is a multicenter collaboration reporting processes and outcomes of care for patients treated with RFA for BE. PATIENTS: Patients enrolled with BE. INTERVENTIONS: RFA. MAIN OUTCOME MEASUREMENTS: We assessed safety (stricture, bleeding, perforation, hospitalization), efficacy (complete eradication of intestinal metaplasia [CEIM]), complete eradication of dysplasia, and number of treatments to CEIM by sex and race and/or ethnicity. RESULTS: Among 5521 patients (4052 men; 5126 white, 137 Hispanic, 82 African American, 40 Asian, 136 heritage not identified), women were younger (60.0 vs 62.1 years) and had shorter BE segments (3.2 vs 4.4 cm) and less dysplasia (37% vs 57%) than did men. Women were almost twice as likely to stricture (odds ratio 1.7; 95% confidence interval, 1.2-2.3). Although white patients were predominantly male, about half of African Americans and Asians with BE were female. African Americans and Asians had less dysplasia than white patients. Asians and African Americans had more strictures than did white patients. There were no sex or race differences in efficacy. LIMITATIONS: Observational study with non-mandated paradigms, no central laboratory for reinterpretation of pathology. CONCLUSION: In the U.S. RFA patient registry, women had shorter BE segments and less-aggressive histology. The usual tendency toward BE in men was absent in African Americans and Asians. Posttreatment stricture was more common among women and Asians. RFA efficacy did not differ by sex or race.
Authors: Farzaneh Banki; Steven R Demeester; Rodney J Mason; Guilherme Campos; Jeffrey A Hagen; Jeffrey H Peters; Cedric G Bremner; Tom R Demeester Journal: Am J Gastroenterol Date: 2005-03 Impact factor: 10.864
Authors: Gary W Falk; Prashanthi N Thota; Joel E Richter; Jason T Connor; Don M Wachsberger Journal: Clin Gastroenterol Hepatol Date: 2005-11 Impact factor: 11.382
Authors: Claudia R Baquet; Patricia Commiskey; Kelly Mack; Stephen Meltzer; Shiraz I Mishra Journal: J Natl Med Assoc Date: 2005-11 Impact factor: 1.798
Authors: E Montgomery; M P Bronner; J R Goldblum; J K Greenson; M M Haber; J Hart; L W Lamps; G Y Lauwers; A J Lazenby; D N Lewin; M E Robert; A Y Toledano; Y Shyr; K Washington Journal: Hum Pathol Date: 2001-04 Impact factor: 3.466
Authors: Alexander C Ford; David Forman; P Dominic Reynolds; Brian T Cooper; Paul Moayyedi Journal: Am J Epidemiol Date: 2005-08-02 Impact factor: 4.897
Authors: Fateh Bazerbachi; Jason D Heffley; Barham K Abu Dayyeh; Jose Nieto; Eric J Vargas; Tarek Sawas; Raja Zaghlol; Navtej S Buttar; Mark D Topazian; Louis M Wong Kee Song; Michael Levy; Steve Keilin; Qiang Cai; Field F Willingham Journal: Endosc Int Open Date: 2017-09-12