Esophageal Radiofrequency Ablation for the Treatment of Intestinal Metaplasia, Low Grade Dysplasia, and High Grade Dysplasia

The presence of intestinal metaplasia (IM) of the esophagus is associated with an elevated risk for developing high-grade dysplasia and invasive adenocarcinoma. Historically, IM has been surveyed with a lifetime of serial endoscopy and biopsy procedures to monitor for the development of high-grade dysplasia and cancer, the early detection of which would permit intervention with surgery. Several nonsurgical endoscopic procedures have been developed with the intent to eradicate IM and dysplasia and halt progression to invasive cancer. However, many of these techniques have been associated with significant morbidity and unacceptable efficacy outcomes. Radiofrequency ablation (RFA) has more recently been studied to eradicate IM and dysplasia of the esophagus. This manuscript will review the technique, clinical results, and recommendations for RFA.