Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer

Oh, Eui Geum; Kim, Nayoung; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong Hoon; Ye, Byong Duk; Myung, Seung Jae; Yang, Suk Kyun; Yu, Chang Sik; Kim, Jin Cheon

doi:10.1016/j.gie.2021.02.021

Cited by 18 publications

(12 citation statements)

References 34 publications

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“…Selected superficially invasive cancers can also be resected by en-bloc EMR or ESD. Endoscopic resection of unrecognized malignant polyps with superficial submucosal invasive cancer (SMIC), with subsequent surgical resection, is not associated with increased risk of lymph node metastasis recurrence or decreased long-term recurrence-free survival, even with high-risk histologic features ( 30 , 31 ).…”

Section: Complex Polypmentioning

confidence: 99%

Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends

et al. 2022

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Most colorectal cancers arise from adenomatous polyps and sessile serrated lesions. Screening colonoscopy and therapeutic polypectomy can potentially reduce colorectal cancer burden by early detection and removal of these polyps, thus decreasing colorectal cancer incidence and mortality. Most endoscopists are skilled in detecting and removing the vast majority of polyps endoscopically during a routine colonoscopy. Polyps can be considered “complex” based on size, location, morphology, underlying scar tissue, which are not amenable to removal by conventional endoscopic polypectomy techniques. They are technically more challenging to resect and carry an increased risk of complications. Most of these polyps were used to be managed by surgical intervention in the past. Rapid advancement in endoscopic resection techniques has led to a decreasing role of surgery in managing these complex polyps. These endoscopic resection techniques do require an expert in the field and advanced equipment to perform the procedure. In this review, we discuss various advanced endoscopic techniques for the management of complex polyps.

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Section: Complex Polypmentioning

confidence: 99%

Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends

et al. 2022

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“…In conclusion, the study by Oh et al 11 supports the primary role of endoscopic resection for malignant polyps (T1 CRC) with anticipated superficial SMI and low risk of lymph node metastasis. Importantly, oncologic outcomes were not compromised in cases where endoscopic resection did not provide curative therapy and secondary surgery was needed.…”

mentioning

confidence: 63%

“…Advances in endoscopic technology and techniques have expanded the curative potential of endoscopic resection of selected malignant polyps and its application in clinical practice. The study by Oh et al 11 demonstrates that attempts at endoscopic resection of T1 CRC did not negatively affect the risk of cancer recurrence after secondary surgery. The strengths of this study include the enrollment of a large number of patients with a long follow-up duration after surgery.…”

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confidence: 94%

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Endoscopic resection of T1 colorectal cancer before surgery does not affect recurrence

Yang

Draganov

2021

Gastrointestinal Endoscopy

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“…This approach is further supported by mounting evidence indicating that ESD does not adversely affect long-term oncologic outcomes following secondary surgery for noncurative resection. 6 Importantly, it should be emphasized that not all patients with endoscopic R1 resection of T1 colorectal cancer require secondary surgery. As a matter of fact, this "ESD for all LSTs devoid of overt signs of deep SMIC" is the current approach in Japan.…”

Section: Colorectal Endoscopic Submucosal Dissectionmentioning

confidence: 99%

Clinical Updates in Colorectal Endoscopic Submucosal Dissection

Yang

Draganov

2022

Clinical Gastroenterology and Hepatology

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L aterally spreading tumors (LSTs) are increasingly encountered with the uptake of colorectal cancer screening programs. The approach to LSTs is determined by the risk of submucosal invasive cancer (SMIC), because this dictates the most appropriate endoscopic or surgical intervention. In the West, endoscopic mucosal resection (EMR) is the first-line treatment for LSTs without SMIC, given its cost-effectiveness, superior safety profile, and patient quality of life when compared with surgery. Conversely, LSTs with SMIC have been traditionally referred for surgery. More recently, colorectal endoscopic submucosal dissection (ESD), has emerged as a minimally invasive alternative to surgery for LSTs with superficial SMIC. ESD enables the en bloc resection of lesions irrespective of size, which confers 2 distinct advantages: an ideal specimen for accurate histologic assessment and low risk for recurrence.

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Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer

Cited by 18 publications

References 34 publications

Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends

Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends

Endoscopic resection of T1 colorectal cancer before surgery does not affect recurrence

Clinical Updates in Colorectal Endoscopic Submucosal Dissection

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