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Endoscopy 2010; 42(10): 790-799
DOI: 10.1055/s-0030-1255780
Original article
 
© Georg Thieme Verlag KG Stuttgart · New York

Quality of life following radiofrequency ablation of dysplastic Barrett’s esophagus

N.  J.  Shaheen1 , A.  F.  Peery1 , R.  H.  Hawes2 , R.  I.  Rothstein3 , S.  J.  Spechler4 , J.  A.  Galanko1 , M.  Campbell1 , C.  Carr1 , B.  Fowler1 , J.  Walsh1 , A.  A.  Siddiqui4 , A.  Infantolino5 , H.  C.  Wolfsen6 , for the AIM Dysplasia Trial Investigators[*]
  • 1University of North Carolina School of Medicine and School of Public Health, Chapel Hill, North Carolina, USA
  • 2Medical University of South Carolina, Charleston, South Carolina, USA
  • 3Dartmouth Hitchcock Foundation, Lebanon, New Hampshire, USA
  • 4University of Texas, Southwestern, Dallas, Texas, USA
  • 5Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  • 6Mayo Clinic Jacksonville, Jacksonville, Florida, USA
Further Information

Publication History

submitted 20 May 2010

accepted after revision 23 August 2010

Publication Date:
30 September 2010 (online)

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Background and study aims: The impact of the diagnosis and treatment of dysplastic Barrett’s esophagus on quality of life (QoL) is poorly understood. This study assessed the influence of dysplastic Barrett’s esophagus on QoL and evaluated whether endoscopic treatment of dysplastic Barrett’s esophagus with radiofrequency ablation (RFA) improves QoL.

Patients and methods: We analyzed changes in QoL in the AIM Dysplasia Trial, a multicenter study of patients with dysplastic Barrett’s esophagus who were randomly allocated to RFA therapy or a sham intervention. We developed a 10-item questionnaire to assess the influence of dysplastic Barrett’s esophagus on QoL. The questionnaire was completed by patients at baseline and 12 months.

Results: 127 patients were randomized to RFA (n = 84) or sham (n = 43). At baseline, most patients reported worry about esophageal cancer (71 % RFA, 85 % sham) and esophagectomy (61 % RFA, 68 % sham). Patients also reported depression, impaired QoL, worry, stress, and dissatisfaction with the condition of their esophagus. Of those randomized, 117 patients completed the study to the 12-month end point. Compared with the sham group, patients treated with RFA had significantly less worry about esophageal cancer (P = 0.003) and esophagectomy (P = 0.009). They also had significantly reduced depression (P = 0.02), general worry about the condition of their esophagus (P ≤ 0.001), impact on daily QoL (P = 0.009), stress (P = 0.03), dissatisfaction with the condition of their esophagus (P ≤ 0.001), and impact on work and family life (P = 0.02).

Conclusions: Inclusion in the treatment group of this randomized, sham-controlled trial of RFA was associated with improvement in disease-specific health-related quality of life. This improvement appears secondary to a perceived decrease in the risk of cancer.

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1 See Appendix 1.

2 All institutions and locations are in the US.

N. J. ShaheenMD, MPH 

University of North Carolina School of Medicine

CB#7080
Chapel Hill, NC 27599–7080

Fax: +1-919-843-2508

Email: nshaheen@med.unc.edu

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