Clinical outcomes of deep invasive submucosal colorectal cancer after ESD

Watanabe, Daisuke; Toyonaga, Takashi; Ooi, Makoto; Yoshizaki, Tetsuya; Ohara, Yoshiko; Tanaka, Shinwa; Kawara, Fumiaki; Ishida, Tatsuro; Morita, Yoshinori; Umegaki, Eiji; Matsuda, Takeru; Sumi, Yasuo; Nishio, Masaki; Yokozaki, Hiroshi; Azuma, Takeshi

doi:10.1007/s00464-017-5910-5

Cited by 37 publications

(24 citation statements)

References 23 publications

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“…While HGD and SM-s carcinoma can be completely cured by endoscopic resection, SM-d carcinoma requires surgery because of the risk of lymph node metastasis; therefore, it is important to distinguish between the two. Because endoscopic treatment of SM-d carcinoma does not affect the prognosis after additional surgery, as shown in previous reports (including within our department 46,47 ), it is important to avoid over-diagnosis. There are few reports about the CADx of SM-d carcinoma diagnosis by endoscopy so far, and there are few reports with a specificity of 90% or more [30][31][32][33] ; the specificity of the Type 3 lesion for our CADx was 99.6%.…”

Section: Discussionsupporting

confidence: 55%

Development of multi‐class computer‐aided diagnostic systems using the NICE/JNET classifications for colorectal lesions

Okamoto

Yoshida

Izakura

et al. 2021

J of Gastro and Hepatol

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Background and Aim: Diagnostic support using artificial intelligence may contribute to the equalization of endoscopic diagnosis of colorectal lesions. We developed computer-aided diagnosis (CADx) support system for diagnosing colorectal lesions using the NBI International Colorectal Endoscopic (NICE) classification and the Japan NBI Expert Team (JNET) classification. Methods: Using Residual Network as the classifier and NBI images as training images, we developed a CADx based on the NICE classification (CADx-N) and a CADx based on the JNET classification (CADx-J). For validation, 480 non-magnifying and magnifying NBI images were used for the CADx-N and 320 magnifying NBI images were used for the CADx-J. The diagnostic performance of the CADx-N was evaluated using the magnification rate. Results: The accuracy of the CADx-N for Types 1, 2, and 3 was 97.5%, 91.2%, and 93.8%, respectively. The diagnostic performance for each magnification level was good (no statistically significant difference).

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Section: Discussionsupporting

confidence: 55%

Development of multi‐class computer‐aided diagnostic systems using the NICE/JNET classifications for colorectal lesions

Okamoto

Yoshida

Izakura

et al. 2021

J of Gastro and Hepatol

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“…Briefly, intact layers of mesocolon was separated from the parietal plane and a maximum number of harvested LNs via true central ligation of the supplying vessels at their roots during TME or CME. The anatomical basis of this approach is that there exists an innate natural space between the mesocolon covered by an enveloped visceral layer and the retroperitoneal parietal plane which is called Toldt’s space [ 16 , 17 ]. But it is not directly applicable for en bloc mesogastrium excision (EME) because the stomach has embryologically unique mesenteries compared with the colon.…”

Section: Discussionmentioning

confidence: 99%

Modularized laparoscopic regional en bloc mesogastrium excision (rEME) based on membrane anatomy for distal gastric cancer

Shen

Dong

et al. 2018

Surg Endosc

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BackgroundThe purpose of the study was to evaluate the safety and feasibility of a new surgical procedure named modularized laparoscopic regional En bloc mesogastrium excision (rEME) based on the membrane anatomy in distal laparoscopic radical gastrectomy for gastric cancer.MethodsFrom January 2014 to June 2017, 92 consecutive cases of patients with stages I–III distal gastric cancer were divided into 2 groups: laparoscopic radical gastrectomy plus standard D2 lymph node dissection (SD group, n = 44) and modularized rEME (rEME group, n = 48). Evaluations were made in terms of the operative data, pathological results, recovery time of digestive tract functions, complications, and length of stay.Results85 patients (SD group, n = 40 and rEME group, n = 45) were finally included for analysis. There were no significant differences in the median total numbers of dissected LNs (31.98 ± 10.48 vs. 34.93 ± 13.12, p = 0.261), LNs in the greater curvature (12.18 ± 6.55 vs. 13.62 ± 8.09, p = 0.444), LNs in the lesser curvature (19.55 ± 7.40 vs. 17.98 ± 8.31, p = 0.365) between the SD and rEME groups. The rEME group showed lower loss of blood volume (107.11 ± 60.13 ml vs. 146.25 ± 85.78 ml, p = 0.019). No significant differences were found in recovery time of digestive tract functions, postoperative complication rates and length of hospital stay between the two groups.ConclusionLaparoscopic radical gastrectomy plus modularized rEME based on the membrane anatomy is a safe and feasible procedure for distal gastric cancer.

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“…However, several studies have reported that endoscopic resection of T1 CRC before surgical resection does not affect adverse events and recurrence. [64][65][66][67][68][69] Overwater et al 64 described that no significant differences were observed between primary and secondary surgical resection for the presence of LNM (OR, 0.97; 95% CI, 0.49 to 1.93; p=0.940) and recurrence (hazard ratio, 0.97; 95% CI, 0.41 to 2.34; p=0.954). Moreover, Yamashita et al 65 and Yamaoka et al 66 reported that there were no significant differences between primary and secondary surgery groups regarding recurrence after propensity-score matching (1.9% vs 3.1%, p=0.4740 and 1.3% vs 1.3%, p=1.00, respectively).…”

Section: Endoscopic Resection As a First-line Treatmentmentioning

confidence: 99%

Risk Stratification of T1 Colorectal Cancer Metastasis to Lymph Nodes: Current Status and Perspective

et al. 2021

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With the widely spreading population-based screening programs for colorectal cancer and recent improvements in endoscopic diagnosis, the number of endoscopic resections in subjects with T1 colorectal cancer has been increasing. Some reports suggest that endoscopic resection prior to surgical resection of T1 colorectal cancer has no adverse effect on prognosis and contributes to this tendency. The decision on the need for surgical resection as an additional treatment after endoscopic resection of T1 colorectal cancer should be made according to the metastasis risk to lymph nodes based on histopathological findings. Because lymph node metastasis occurs in approximately 10% of patients with T1 colorectal cancer according to current international guidelines, the remaining 90% of patients may be at an increased risk of surgical resection and associated postoperative mortality, with no clinical benefit derived from unnecessary surgical resection. Although a more accurate prediction system for lymph node metastasis is needed to solve this problem, risk stratification for lymph node metastasis remains controversial. In this review, we focus on the current status of risk stratification of T1 colorectal cancer metastasis to lymph nodes and outline future perspectives.

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Clinical outcomes of deep invasive submucosal colorectal cancer after ESD

Abstract: ESD for T1b CRC before surgery is a possible strategy because of the low rate of complications and favorable long-term outcomes.

Cited by 37 publications

References 23 publications

Development of multi‐class computer‐aided diagnostic systems using the NICE/JNET classifications for colorectal lesions

Development of multi‐class computer‐aided diagnostic systems using the NICE/JNET classifications for colorectal lesions

Modularized laparoscopic regional en bloc mesogastrium excision (rEME) based on membrane anatomy for distal gastric cancer

Risk Stratification of T1 Colorectal Cancer Metastasis to Lymph Nodes: Current Status and Perspective

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