A large-scale multicenter study of long-term outcomes after endoscopic resection for submucosal invasive colorectal cancer

Yoda, Yusuke; Ikematsu, Hiroaki; Matsuda, Takahisa; Yamaguchi, Yoshihiro; Kobayashi, Nozomu; Fujii, Takeshi; Oono, Yasuhiro; Sakamoto, Taku; Nakajima, Takeshi; Takao, Madoka; Shinohara, Tomoaki; Fujimori, Takahiro; Kaneko, Kazuhiro; Saito, Yutaka

doi:10.1055/s-0033-1344234

Cited by 127 publications

(123 citation statements)

References 19 publications

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“…Colorectal surgery is however associated with an overall mortality of 1–5% and morbidity of about 30%, especially in the elderly population 1–4. A recent study from Japan showed that endoscopic resection is adequate for T1 CRC with a low risk for lymph node metastasis (LNM), which concerns approximately 19–29% of all T1 CRCs 5 6. Additional surgical resection is required for high-risk T1 CRC 5…”

Section: Introductionmentioning

confidence: 99%

Endoscopic resection of high-risk T1 colorectal carcinoma prior to surgical resection has no adverse effect on long-term outcomes

Overwater

Kessels

Elias

et al. 2016

Gut

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Section: Introductionmentioning

confidence: 99%

Endoscopic resection of high-risk T1 colorectal carcinoma prior to surgical resection has no adverse effect on long-term outcomes

Overwater

Kessels

Elias

et al. 2016

Gut

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“…Careful lesion assessment before EMR or ESD is essen tial, primarily to avoid an attempt at endoscopic resection in a lesion containing deep submucosal invasion, which would be hazardous (increased risk of perforation) and would probably result in incomplete excision 7,39,40 . All lesions should be classified according to gross morpho logy using the internationally recognized Paris classifica tion 41 .…”

Section: Lesion Assessmentmentioning

confidence: 99%

Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps

Saunders

Tsiamoulos

2016

Nat Rev Gastroenterol Hepatol

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Almost all large and complex colorectal polyps can now be resected endoscopically. Piecemeal endoscopic mucosal resection (PEMR) is an established technique with fairly low complication risk and good short-term and medium-term outcomes. Several modifications to the basic injection and snare technique have been developed contributing to safer and more complete resections. Delayed bleeding requiring reintervention is the most troublesome complication in 2-7% of patients, particularly in those with comorbidities and large, right-sided polyps. Endoscopic submucosal dissection (ESD) has become popular in Japan and has theoretical advantages over PEMR in providing a complete, en bloc excision for accurate histological staging and reduced local recurrence. These advantages come at the cost of a more complex, expensive and time-consuming procedure with a higher risk of perforation, particularly early in the procedure learning curve. These factors have contributed to the slow adoption of ESD in the West and the challenge to develop new devices and endoscopic platforms that will make ESD easier and safer. Currently, ESD indications are limited to large rectal lesions, in which procedural complications are easily managed, and for colorectal polyps with a high risk of containing tiny foci of early submucosally invasive cancer, whereby ESD may be curative compared with PEMR.

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“…Application of immunohistochemistry for D2-40 and desmin is informative to accurately detect vascular invasion and depth of submucosal invasion. Two large-scale retrospective multicenter cohort studies have shown that for patients with submucosal invasive CRC without the above risk factors, the 5-year overall survival rates were similar whether they were treated by endoscopic resection alone or underwent endoscopic resection with subsequent surgery [37,38]. …”

Section: Histological Assessmentmentioning

confidence: 99%

Endoscopic Approach for Superficial Colorectal Neoplasms

Xu¹,

Yang

Jin

et al. 2016

Gastrointest Tumors

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Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females, with an estimated 1.4 million cases and 693,900 deaths in 2012. Colonoscopy is the cornerstone for the detection and prevention of CRC. In addition, endoscopic treatment for CRC at an early stage can effectively improve patients' quality of life and cure rate. Summary: This review focuses on endoscopic approaches, including white light endoscopy, chromoendoscopy, magnifying endoscopy and therapeutic endoscopy, for the evaluation and treatment of superficial colorectal neoplasms. Key Message: Understanding the preoperative evaluation, indications and techniques of endoscopic mucosal resection/endoscopic submucosal dissection as well as postoperative surveillance for superficial colorectal neoplasms is critical for providing appropriate management to the patients. Practical Implications: Endoscopic therapy, a method preserving organ function and improving quality of life, is a widely applied microinvasive treatment for superficial colorectal neoplasms. This review describes the basics and developments of endoscopic approaches and may facilitate daily practice for superficial colorectal neoplasms.

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A large-scale multicenter study of long-term outcomes after endoscopic resection for submucosal invasive colorectal cancer

Abstract: Endoscopic resection alone is adequate for the management of patients with SM-CRC and low risk features. However, in those patients with SM-CRC and high risk features, surgery should be considered in addition to endoscopic resection.

Cited by 127 publications

References 19 publications

Endoscopic resection of high-risk T1 colorectal carcinoma prior to surgical resection has no adverse effect on long-term outcomes

Endoscopic resection of high-risk T1 colorectal carcinoma prior to surgical resection has no adverse effect on long-term outcomes

Endoscopic mucosal resection and endoscopic submucosal dissection of large colonic polyps

Endoscopic Approach for Superficial Colorectal Neoplasms

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