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Surgical Endoscopy

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01-09-2020 | Colonoscopy

Long-term outcomes of endoscopically resected laterally spreading tumors with a positive histological lateral margin

Authors: Eun Young Park, Dong Hoon Baek, Geun Am Song, Gwang Ha Kim, Bong Eun Lee, Do Youn Park

Published in: Surgical Endoscopy | Issue 9/2020

Abstract

Background

With advances in diagnostic endoscopy, the incidence of superficial colorectal tumors, including laterally spreading tumors (LSTs), has increased. However, little is known about the long-term results of LSTs with positive lateral margin after endoscopic treatment. This study aimed to evaluate the long-term clinical outcomes and risk factors for local recurrence of LSTs with positive lateral margin after initial endoscopic resection.

Methods

We performed a retrospective analysis of the medical records of 324 patients who had 363 LSTs with positive lateral margin after endoscopic resection at a tertiary academic medical center. The medical records from 2011 to 2015 were analyzed. Local recurrence was confirmed through endoscopic finding and subsequent biopsy analysis. We assessed the local recurrence rate and performed multivariate analyses to identify the factors associated with local recurrence.

Results

Follow-up colonoscopy was performed in 176 of 363 LSTs. The local recurrence rate was 6.3% (11/176), with a median (interquartile range [IQR]) follow-up period of 19.8 (12.4–46.5) months. In multivariate analysis, local recurrence was associated with piecemeal resection (odds ratio [OR] 6.62, 95% confidence interval [CI] 1.28–34.33; p = 0.024) and inversely associated with thermal ablation (OR 0.033, 95% CI 0.00–0.45; p = 0.011). At surveillance colonoscopy, histology of the recurrent tumor was adenoma in 10 (90.9%) of 11; these were treated endoscopically.

Conclusions

In this retrospective study, we found that endoscopically resected LSTs with positive lateral margin have a low recurrence rate. Piecemeal resection was associated with higher local recurrence, and thermal ablation was inversely associated with local recurrence. Endoscopic resection with positive lateral margin combined with thermal ablation leads to a low recurrence rate.

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Title: Long-term outcomes of endoscopically resected laterally spreading tumors with a positive histological lateral margin
Authors: Eun Young Park
Dong Hoon Baek
Geun Am Song
Gwang Ha Kim
Bong Eun Lee
Do Youn Park
Publication date: 01-09-2020
Publisher: Springer US
Keyword: Colonoscopy
Published in: Surgical Endoscopy / Issue 9/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07187-x

At a glance: The STEP trials

Springer Medicine

Long-term outcomes of endoscopically resected laterally spreading tumors with a positive histological lateral margin

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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