Conditions of curability after endoscopic resection for colorectal carcinoma with submucosally massive invasion.

Tanaka, Shinji; Haruma, Ken; Ohe, Hirotoki; Nagata, Shinji; Hirota, Y; Furudoi, Akira; Amioka, Toru; Kitadai, Yasuhiko; Yoshihara, Masaharu; Shimamoto, Fumio

doi:10.3892/or.7.4.783

Cited by 48 publications

(50 citation statements)

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“…Furthermore, Tanaka et al (47) reported that well-or moderately differentiated carcinomas within 1,500 µm invasion are curative by EMR, provided that no vascular involvement is observed.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

Santos¹,

Malaman²,

Pereira-Lima

2011

Arq. Gastroenterol.

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-Context -Endoscopic mucosal resection is a minimally invasive technique used in the treatment of colorectal neoplasms, including early carcinomas of different size and morphology. Objectives -To evaluate procedure safety, efficacy, outcomes, and recurrence rate in endoscopic mucosal resection of colorectal lesions. Methods -A total of 172 lesions in 156 patients were analyzed between May 2003 and May 2009. All lesions showed pit pattern suggestive of neoplasia (Kudo types III-V) at high-magnification chromocolonoscopy with indigo carmine. The lesions were evaluated for macroscopic classification, size, location, and histopathology. Lesions 20 mm or smaller were resected en bloc and lesions larger than 20 mm were removed using the piecemeal technique.Complications and recurrence were analyzed. Patients were followed up for 18 months. Results -There were 83 (48.2%) superficial lesions, 57 (33.1%) depressed lesions, 44 (25.6%) laterally spreading tumors, and 45 (26.2%) protruding lesions. Mean lesion size was 11.5 mm ± 9.6 mm (2 mm-60 mm). Patients' mean age was 61.6 ± 12.5 years (34-93 years). Regarding lesion site, 24 (14.0%) lesions were located in the rectum, 68 (39.5%) in the left colon, and 80 (46.5%) in the right colon (transverse, ascending, and cecum). There were 167 (97.1%) neoplasms: 142 (82.5%) adenomatous lesions, 24 (14.0%) intramucosal carcinomas, and 1 (0.6%) invasive carcinoma. En bloc resection was performed in 158 (91.9%) cases and piecemeal resection in 14 (8.1%). Bleeding occurred in 5 (2.9%) cases. Recurrence was observed in 4.1% (5/122) of cases and was associated with lesions larger than 20 mm (P<0.01), piecemeal resection (P<0.01), advanced neoplasm (P = 0.01), and carcinoma compared to adenoma (P = 0.04). Conclusions -Endoscopic mucosal resection of colorectal lesions is a safe and effective procedure, with low complication and local recurrence rates. Recurrence is associated with lesions larger than 20 mm and carcinomas.

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“…Furthermore, Tanaka et al (47) reported that well-or moderately differentiated carcinomas within 1,500 µm invasion are curative by EMR, provided that no vascular involvement is observed.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

Santos¹,

Malaman²,

Pereira-Lima

2011

Arq. Gastroenterol.

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“…Although no diagnostic methods enable prediction of lymph node metastasis (pN) without fail, the risk of metastasis can be used as a basis for determining whether or not to perform additional treatment. Factors such as the depth of submucosal invasion (SM invasion depth) [127], histological type, for example poorly differentiated adenocarcinoma, signet-ring cell carcinoma, and mucinous carcinoma [126], the presence of a poorly-differentiated area and muconodules at the site of deepest invasion, budding, and vascular invasion, have been reported to be risk factors for regional lymph node metastasis by pT1 (SM) carcinoma [126,128].…”

Section: Clinical Questionsmentioning

confidence: 99%

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer

Watanabe

Itabashi²,

Shimada³

et al. 2011

Int J Clin Oncol

663

536

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Guidelines 2014) have been prepared as standard treatment strategies for colorectal cancer, to eliminate treatment disparities among institutions, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding among health-care professionals and patients by making these guidelines available to the general public. These guidelines have been prepared as a result Abstract Colorectal cancer is a major cause of death in Japan, where it accounts for the largest number of deaths from malignant neoplasms among women and the third largest number among men. Many new methods of treatment have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2014 for treatment of colorectal cancer (JSCCR

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“…O surgimento destas metástases torna-se possível a partir da invasão da camada submucosa quando a lesão passa a ser conceituada como carcinoma invasivo 4 . A ocorrência de implantes metastáticos linfonodais nesse contexto, varia de 3,6-16,2% e de metástases viscerais, de aproximadamente 3,0% [32][33][34] . Para que não seja necessário o tratamento complementar no carcinoma invasor, ele deve ser totalmente excisado, ter avaliação completa da profundidade da invasão, ser bem ou moderadamente diferenciado, não ter invasão linfo-vascular nem comprometimento das margens de ressecção 13 .…”

Section: Discussionunclassified

Variabilidade interobservador no diagnóstico histológico dos pólipos colorretais

Cerato

Meurer³

et al. 2007

Rev bras. colo-proctol.

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RESUMO: O manejo clínico dos pacientes com pólipos colorretais é principalmente baseado na histologia das lesões removidas. Em conseqüência, o diagnóstico histológico tem um papel muito importante na decisão terapêutica e a uniformidade de interpretação dos diferentes laudos de patologia é essencial. Apesar destas relevantes implicações, poucos estudos existem avaliando a variabilidade interobservador na elucidação dessa doença e a concordância não é considerada satisfatória. Objetivo: avaliar a variabilidade interobservador no diagnóstico histológico dos pólipos colorretais. Metodologia: foram avaliados 230 pólipos colorretais no Serviço de Patologia do Hospital de Clínicas de Porto Alegre (HCPA). Quatro patologistas examinaram todas as lâminas de forma independente e "cega", ou seja, sem conhecimento do diagnóstico elaborado pelo seu colega. As lesões colorretais foram classificadas em relação ao diagnóstico: pólipo e carcinoma invasivo e quanto ao tipo de pólipo: adenomatoso versus hiperplásico. Nos adenomas foram avaliados o tipo histológico (tubular, túbulo-viloso e viloso) e o grau de displasia (baixo e alto grau).Resultados: o Kappa médio, em relação ao tipo de lesão, foi de 0,794, considerado moderado. Quanto ao tipo de pólipo, o Kappa médio foi 0,852, ou seja, uma ótima concordância. Em relação aos adenomas, no que se refere ao tipo histológico, obteve-se um Kappa médio, fraco de 0,291, e na avaliação do grau de displasia o Kappa médio foi regular com valor de 0,420. Conclusão: o índice de concordância, entre os quatro observadores foi considerado de moderado a ótimo no tipo de lesão e de pólipo, porém a variabilidade foi grande na avaliação dos adenomas, tanto no que concerne ao tipo histológico quanto ao grau de displasia com um Kappa de fraco a regular.

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Conditions of curability after endoscopic resection for colorectal carcinoma with submucosally massive invasion.

Cited by 48 publications

References 0 publications

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

Endoscopic mucosal resection in colorectal lesion: a safe and effective procedure even in lesions larger than 2 cm and in carcinomas

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer

Variabilidade interobservador no diagnóstico histológico dos pólipos colorretais

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