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Long-term outcomes of endoscopic treatment for colorectal laterally spreading tumor: a large-scale multicenter retrospective study from China

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Abstract

Background

Laterally spreading tumor (LST) is a type of precancerous lesion of colorectal cancer with high malignant potential. The present study aimed to evaluate long-term outcomes of endoscopic treatment for LST in Chinese patients.

Methods

This study was a retrospective review of data collected from 653 included patients with LST from six regional representative hospitals in China between January 2007 and January 2017. Demographic characteristics, endoscopic features of LST, operation-related data, and follow-up results were collected and analyzed.

Results

LST-granular type (LST-G, 80.3%) was much more common than LST-non-grandular type (LST-NG, 19.7%). The overall submucosal invasion rate of all LSTs was 6.1% and the submucosal invasion rate of LST-NG was significantly higher than that of LST-G (6.79% vs. 3.87%, p = 0.000). The en bloc resection rate of ESD and EMR treatment was 96% and 93.7%, respectively, with pathologic R0 resection rate of 90.1% and 82.8%. After an average duration of follow-up about 34.52 ± 11.76 months, the recurrence rate of ESD was 3.47%, and the recurrence rate of EMR was 8.8% after an average follow-up of about 38.44 ± 4.42 months. However, the recurrence rate of ESD was much lower than piecemeal EMR for LST (3.47% vs. 8.62%, p = 0.017). Retroflexion-assisted technique applied for resection of rectal LST was associated with a significantly shortened operating time (85.40 min vs. 174.18 min, p = 0.002).

Conclusion

Endoscopic resection is a safe and efficient modality for the treatment of colorectal LST with a relatively low recurrence rate and shortened operating time with the use of retroflexion.

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Abbreviations

EMR:

Endoscopic mucosal resection

REMR:

Retroflexion-assisted endoscopic mucosal resection

LSTs:

Laterally spreading tumors

APC:

Argon plasma coagulation

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Acknowledgements

We want to express our gratitude to the Science and Technology Planning Project of Guangdong Province (2017A020215139). Guangdong gastrointestinal disease research center (No. 2017B020209003).

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Author notes

  1. Yue Li and Yue Zhang contributed equally to this paper.

Authors and Affiliations

  1. Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Yue Li, Yue Zhang, Yusi Wang, Qiang Zhang, Fachao Zhi & Side Liu

  2. Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Yue Li, Fayad Lea & Vivek Kumbhari

  3. Department of Gastroenterology, Southwest Hospital, Army Medical University, Chongqing, 400038, China

    Yao Chen & Guiyong Peng

  4. Department of Endoscopy, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China

    Lizhou Dou & Guiqi Wang

  5. Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China

    Xianfei Wang

  6. Department of Gastroenterology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China

    Qiang Zhan & Guoqiang Zhang

  7. Department of Gastroenterology, The Second Affiliated Hospital, Guangxi Medical University, Nanning, 530000, China

    Mengbin Qin & Jiean Huang

  8. Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Side Liu

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  1. Yue Li
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Contributions

SL and YL designed the study. SL, JH, QZ, FZ, GP, GW performed some cases. YZ, YW, YC, LD, XW, QZ, GZ, and MQ recorded the data. YL and YZ analyzed the data and drafted the manuscript. FL and KV revised the manuscript. All authors have read and approved the submitted version of the paper.

Corresponding author

Correspondence to Side Liu.

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Disclosure

Yue Li, Yue Zhang, Yao Chen, Yusi Wang, Lizhou Dou, Xianfei Wang, Qiang Zhan, Guoqiang Zhang, Mengbin Qin, Fayad Lea, Jiean Huang, Qiang Zhang, Fachao Zhi, Guiyong Peng, Guiqi Wang, Vivek Kumbhari, Side Liu have no conflicts of interest or financial ties to disclose.

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Li, Y., Zhang, Y., Chen, Y. et al. Long-term outcomes of endoscopic treatment for colorectal laterally spreading tumor: a large-scale multicenter retrospective study from China. Surg Endosc 35, 736–744 (2021). https://doi.org/10.1007/s00464-020-07440-8

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  • DOI: https://doi.org/10.1007/s00464-020-07440-8

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