Long-term Recurrence-free Survival After Standard Endoscopic Resection Versus Surgical Resection of Submucosal Invasive Colorectal Cancer: A Population-based Study

Belderbos, Tim D.; Erning, Felice N. van; Hingh, Ignace H. J. T. de; Oijen, Martijn G.H. van; Lemmens, Valery; Siersema, Peter D.

doi:10.1016/j.cgh.2016.08.041

Cited by 67 publications

(73 citation statements)

References 31 publications

(46 reference statements)

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“…227 However, one study has reported significantly lower recurrence-free survival rates and higher colorectal cancer-specific mortalities for endoscopic resection of submucosal colorectal cancer than for surgical treatment (HR, 2.40; 95% CI, 1.75-3.29; p<0.001). 227 In addition, studies comparing endoscopic resection and surgical resection for submucosal colorectal cancer reported local recurrence rates of 2.3%-6.4% for endoscopic resection [228][229][230] and relatively low local recurrence rates of 0.9%-1.87% for surgical resection. [228][229][230] Prognoses after endoscopic and surgical resection depend on whether the submucosal colorectal cancer is associated with a high risk of lymph node metastasis.…”

Section: Early Colorectal Cancermentioning

confidence: 99%

“…227 In addition, studies comparing endoscopic resection and surgical resection for submucosal colorectal cancer reported local recurrence rates of 2.3%-6.4% for endoscopic resection [228][229][230] and relatively low local recurrence rates of 0.9%-1.87% for surgical resection. [228][229][230] Prognoses after endoscopic and surgical resection depend on whether the submucosal colorectal cancer is associated with a high risk of lymph node metastasis. A Korean study conducted in 2014 reported no difference between endoscopic resection and surgical resection in the mean 37 months (6-98 months) cumulative incidence of recurrence in case of mucosal and superficial submucosal colorectal cancer with low risks of lymph node metastasis (p=0.641).…”

Section: Early Colorectal Cancermentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

et al. 2020

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Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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Section: Early Colorectal Cancermentioning

confidence: 99%

Section: Early Colorectal Cancermentioning

confidence: 99%

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

et al. 2020

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“…Second, when small submucosal invasive cancers are discarded, the risk for cancer metastasis may not be assessed accurately, and the patients may not be stratified in cancer stages because metastatic risk assessment currently depends on the pathological features of the resected specimens . Favorable 5‐year survival rates of 93.5–97.5% after curative treatments have been reported . On the other hand, the reported 5‐year recurrence‐free survival is poor when patients with T1 cancer who are at “high‐risk” for metastasis were only observed after non‐curative endoscopic resection .…”

Section: Discussionmentioning

confidence: 99%

“…27,28 On the other hand, the reported 5-year recurrence-free survival is poor when patients with T1 cancer who are at "high-risk" for metastasis were only observed after non-curative endoscopic resection. 26,27 Submucosal invasive cancers should be recognized, removed, sent for pathology, and performed complete curative treatments. Endoscopic prediction of diminutive or small polyps with submucosal invasion is crucial, but prediction methods are lacking.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic prediction of advanced histology in diminutive and small colorectal polyps

Iwai

Imai

Ito

et al. 2018

J of Gastro and Hepatol

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“…However, it is worth noting that EMR has also been used for many years to effectively treat early colorectal cancers without high-risk features and that, despite the sound scientific rationale behind recommending en bloc resection using ESD to aid diagnosis and curative resection, no convincing evidence of its benefit over EMR in oncologic outcomes has been published 44–46…”

Section: Introductionmentioning

confidence: 99%

Colorectal endoscopic submucosal dissection: patient selection and special considerations

Emmanuel¹,

Gulati²,

Burt³

et al. 2017

CEG

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Endoscopic submucosal dissection (ESD) enables en bloc resection of large complex colorectal superficial neoplastic lesions, resulting in very low rates of local recurrence, high-quality pathologic specimens for accurate histopathologic diagnosis and potentially curative treatment of early adenocarcinoma without resorting to major surgical resection. The safety and efficacy of the technique, which was pioneered in the upper gastrointestinal tract, has been established by the consistently impressive outcomes from expert centers in Japan and some other eastern countries. However, ESD is challenging to perform in the colorectum and there is a significant risk of complications, particularly in the early stages of the learning curve. Early studies from western centers raised concerns about the high complication rates, and the impressive results from Japanese centers were not replicated. As a result, many western endoscopists are skeptical about the role of ESD and few centers have incorporated the technique into their practice. Nevertheless, although the distribution of expertise, referral centers and modes of practice may differ in Japan and western countries, ESD has an important role and can be safely and effectively incorporated into western practice. Key to achieving this is meticulous lesion assessment and selection, appropriate referral to centers with the necessary expertise and experience and application of the appropriate technique individualized to the patient. This review discusses the advantages, risks and benefits of ESD to treat colorectal lesions and the importance of preprocedure lesion assessment and in vivo diagnosis and outlines a pragmatic rationale for appropriate lesion selection as well as the patient, technical and institutional factors that should be considered.

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Long-term Recurrence-free Survival After Standard Endoscopic Resection Versus Surgical Resection of Submucosal Invasive Colorectal Cancer: A Population-based Study

Abstract: Based on a population analysis of patients diagnosed with T1 CRC, additional surgery after endoscopic resection should be considered only for patients with high-risk histology or a positive resection margin.

Cited by 67 publications

References 31 publications

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

Endoscopic prediction of advanced histology in diminutive and small colorectal polyps

Colorectal endoscopic submucosal dissection: patient selection and special considerations

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