Risk Factors for Unfavorable Outcomes After Endoscopic Removal of Submucosal Invasive Colorectal Tumors

S3-Leitlinie – Kolorektales Karzinom

“…Randomisierte Studien zum Vergleich endoskopischer und chirurgischer Verfahren bei T1-Karzinomen liegen nicht vor. Retrospektive Studien zeigen, dass nach endoskopischer Therapie von low-risk T1-Karzinomen in etwa 3 % mit Rezidiven in Form von Lokalrezidiven oder Fernmetastasen zu rechnen ist [595,604]. Mit dem individuellen Patienten ist deshalb die onkologische Situation zu besprechen und OP-Risiken der onkologischen Resektion gegenüber den Risiken der alleinigen endoskopischen Lokaltherapie darzustellen und abzuwägen.…”

Thin-probe endoscopic ultrasonography for surgical resection of early colorectal neoplasms: A pilot study

“…Meining et al [11] reported that lymphatic vessel infiltration, poor grading of the tumor stage, and incomplete endoscopic resection were risk factors for unfavorable outcomes after endoscopic removal of submucosal invasive colorectal tumors. Among these factors, it might be difficult to predict lymphatic vessel infiltration and incomplete endoscopic resection.…”

Determining the Benefits of Oncologic Surgery After Endoscopic Removal of Submucosal Invasive Colorectal Carcinoma

“…13 A multicenter retrospective analysis of 865 surgically resected submucosal invasive colorectal carcinomas in Japan showed that no lymph node metastasis was seen in pedunculated colorectal carcinoma with head and stalk invasion of less than 3000 m without lymphovascular invasion, and for nonpedunculated lesions none with a submucosal invasion depth of less than 1000 m. 4 These data, although important, were derived from surgically resected specimens, and the clinical outcome of patients receiving sole endoscopic removal of submucosal invasive colorectal carcinoma was sparse. [15][16][17][18] In this issue of Clinical Gastroenterology and Hepatology, Meining et al 19 report a large single-institution outcome study on unfavorable events in patients who had endoscopic resection of submucosal invasive colorectal carcinomas. Over 28 years, 474 patients had endoscopic removal of tumor that was proven to have submucosal invasion.…”