Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett's esophagus: results from the U.S. RFA Registry.

Authors

Sarina Pasricha, University of North Carolina at Chapel Hill
Nan Li, University of North Carolina at Chapel Hill
William J. Bulsiewicz, University of North Carolina at Chapel Hill
Richard I. Rothstein, Dartmouth University School of Medicine
Anthony Infantolino, Thomas Jefferson UniversityFollow
Atilla Ertan, University of Texas School of Medicine
Daniel S. Camara, Digestive Health Physicians
Evan S. Dellon, University of North Carolina at Chapel Hill
George Triadafilopoulos, Stanford University School of Medicine
Charles J. Lightdale, Columbia University School of Medicine
Ryan D. Madanick, University of North Carolina at Chapel Hill
William D. Lyday, Atlanta Gastroenterology Associates
Raman V. Muthusamy, UCLA School of Medicine
Bergein F. Overholt, Gastrointestinal Associates
Nicholas J. Shaheen, University of North Carolina at Chapel Hill

Document Type

Article

Publication Date

8-1-2015

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in Gastrointestinal Endoscopy

Volume 82, Issue 2, August 2015, Pages 276-284.

The published version is available at DOI: 10.1016/j.gie.2015.01.015. Copyright © American Society for Gastrointestinal Endoscopy

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.

Recommended Citation

Pasricha, Sarina; Li, Nan; Bulsiewicz, William J.; Rothstein, Richard I.; Infantolino, Anthony; Ertan, Atilla; Camara, Daniel S.; Dellon, Evan S.; Triadafilopoulos, George; Lightdale, Charles J.; Madanick, Ryan D.; Lyday, William D.; Muthusamy, Raman V.; Overholt, Bergein F.; and Shaheen, Nicholas J., "Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett's esophagus: results from the U.S. RFA Registry." (2015). Department of Medicine Faculty Papers. Paper 176.
https://jdc.jefferson.edu/medfp/176

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

25841575