Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection

Klein, Amir; Tate, David J.; Jayasekeran, Vanoo; Hourigan, Luke F.; Singh, Rajvinder; Brown, Gregor J.; Bahin, Farzan F.; Burgess, Nicholas G.; Williams, Stephen J.; Lee, Eric; Sidhu, Mayenaaz; Byth, Karen; Bourke, Michael J.

doi:10.1053/j.gastro.2018.10.003

Cited by 192 publications

(188 citation statements)

References 38 publications

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“…This study demonstrated that the local colon adenoma recurrence rate in our cohort of patients with ≥ 20-mm colon LSTs managed using cap-fitted colonoscopy with EMR and ablation of the resection edge with APC was low (4.5 %). This adenoma recurrence rate was much lower than 16.0 % to 32 % reported in the literature on traditional EMR for non-pedunculated polyps (▶ Table 3) [3,10,12,[19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 84%

“…We postulate that routine APC ablation of EMR defects using cap fitted colonoscope removes microscopic residual adenoma at the resection edge that is not identified by the endoscopist as shown previously, [20] which accounts for the low recurrence rate in our study (4.5 %). A recent RCT demonstrated significant reduction in adenoma recurrence in patients who underwent ablation of post-EMR defects using snare tip soft coagulation [21]. This method of snare tip coagulation is an attractive option given its simplicity and ▶ Fig.…”

Section: Discussionmentioning

confidence: 99%

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Cap-fitted endoscopic mucosal resection of ≥ 20 mm colon flat lesions followed by argon plasma coagulation results in a low adenoma recurrence rate

et al. 2020

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Background and study aims Endoscopic mucosal resection (EMR) is increasingly used for the treatment of large colonic polyps (≥ 20 mm). A drawback of EMR is local adenoma recurrence. Therefore, we studied the impact of argon plasma coagulation (APC) of the EMR edge on local adenoma recurrence. Patients and methods This was a retrospective study of patients with laterally spreading tumors (LST) ≥ 20 mm, who underwent EMR from January 2009 to August 2018 and follow-up endoscopic assessment. A cap-fitted endoscope was used to assess completeness of resection by systematically inspecting the EMR defect for any macroscopic disease. This was followed by forced APC of the resection edge followed by clip closure of the defect. Surveillance colonoscopy was performed at 6 months after resection to detect recurrence. Results Two hundred forty-six patients met the inclusion criteria. Most were female (53 %) and white (80 %), with a Median age of 64 years. Median polyp size was 35 mm (interquartile range, 30–45 mm). Most polyps were located in the right colon (77 %) and were removed by piecemeal EMR (70 %). Eleven patients (5 %) had residual tumor at the resection site. Conclusions We observed low adenoma recurrence after argon plasma coagulation of the EMR edge with a cap fitted colonoscope in patients with LST ≥ 20 mm of the colon, which requires further validation in a randomized controlled study.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Cap-fitted endoscopic mucosal resection of ≥ 20 mm colon flat lesions followed by argon plasma coagulation results in a low adenoma recurrence rate

et al. 2020

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“…Colon cancer is the third‐most frequent cancer worldwide . Although great treatment advancements have been achieved, the high frequency of recurrence in patients with colon cancer remains the major problem in clinical practice .…”

Section: Introductionmentioning

confidence: 99%

LINC00961 inhibits the migration and invasion of colon cancer cells by sponging miR‐223‐3p and targeting SOX11

Dai

Zhang

et al. 2020

Cancer Medicine

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Long noncoding RNAs play essential roles in colon cancer tumorigenesis. This study aimed to explore the potential function and molecular mechanisms of LINC00961 in colon cancer. qPCR results showed that LINC00961 was downregulated in colon cancer cells and tissues. Functional assays demonstrated that LINC00961 suppressed the migration and invasion of colon cancer cells in vitro. LINC00961 functioned as an endogenous sponge for miR‐223‐3p in colon cancer cells. SOX11 was confirmed as a target gene of miR‐223‐3p. The effect of miR‐223‐3p on colon cancer cells was then investigated. MiR‐223‐3p inhibition enhanced their migration and invasion. The effect of SOX11 on colon cancer cells was studied. SOX11 overexpression inhibited the invasion of colon cancer cells. LINC00961 acted as an anti‐oncogene and upregulated SOX11 expression by functioning as a miR‐223‐3p sponge. This research revealed the molecular mechanism of LINC00961 in colon cancer. LINC00961 might act as a potential diagnostic biomarker and therapeutic target for further clinical treatments.

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“…For example, recent investigation has produced impressive improvements in decreasing polyp recurrence rates after EMR. 19 With the role of prophylactic clipping clarified, we can achieve lower complication rates after EMR of large right colon lesions, which should reduce fear of performing large right colon EMRs. Further, we can improve the cost effectiveness of clipping by refraining from clip use after resection of low risk lesions where no benefit has been demonstrated.…”

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confidence: 99%

Prophylactic Clip Closure Clarified: The Question Is Not Whether to Clip, But When

Rex

2019

Gastroenterology

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Thermal Ablation of Mucosal Defect Margins Reduces Adenoma Recurrence After Colonic Endoscopic Mucosal Resection

Cited by 192 publications

References 38 publications

Cap-fitted endoscopic mucosal resection of ≥ 20 mm colon flat lesions followed by argon plasma coagulation results in a low adenoma recurrence rate

Cap-fitted endoscopic mucosal resection of ≥ 20 mm colon flat lesions followed by argon plasma coagulation results in a low adenoma recurrence rate

LINC00961 inhibits the migration and invasion of colon cancer cells by sponging miR‐223‐3p and targeting SOX11

Prophylactic Clip Closure Clarified: The Question Is Not Whether to Clip, But When

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