Skip to main content
Top
Published in: BMC Gastroenterology 1/2017

Open Access 01-12-2017 | Research article

Efficacy and safety of additional surgery after non-curative endoscopic submucosal dissection for early colorectal cancer

Authors: Tao Chen, Yi-Qun Zhang, Wei-Feng Chen, Ying-Yong Hou, Li-Qing Yao, Yun-Shi Zhong, Mei-Dong Xu, Ping-Hong Zhou

Published in: BMC Gastroenterology | Issue 1/2017

Login to get access

Abstract

Background

Additional surgery is recommended when early colorectal cancer (ECRC) is resected by non-curative endoscopic submucosal dissection (ESD) and there is significant risk of lymph node metastasis (LNM). The aim of this study was to investigate the efficacy and safety of additional surgery after non-curative ESD for ECRC and evaluate long-term outcomes.

Methods

Patients with ECRC who underwent ESD and additional surgery between July 2007 and November 2013 were identified. Histology and patient data were collected during an average period of more than 5 years to determine tumor stage and type, resection status, complications, tumor recurrence, and distant metastasis.

Results

Fifty-one patients who underwent additional surgery were eligible for analysis. Overall, regional LNM was detected in 5 patients (9.8%) and presence of lymphovascular infiltration was a significant risk factor. Surgery-related complications occurred in 3 patients (5.9%). During a median follow-up period of 59 months, no metastasis or local recurrence was observed. Three patients died of other diseases and no CRC-related deaths took place.

Conclusions

Additional surgery after non-curative ESD for ECRC is effective and safe and should be encouraged to foster curative treatment and better long-term outcomes.
Literature
1.
go back to reference Oka S, et al. Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan. Am J Gastroenterol. 2015;110(5):697–707.CrossRefPubMed Oka S, et al. Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan. Am J Gastroenterol. 2015;110(5):697–707.CrossRefPubMed
2.
go back to reference Saito Y, et al. Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors determined by curative resection. Surg Endosc. 2010;24(2):343–52.CrossRefPubMed Saito Y, et al. Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors determined by curative resection. Surg Endosc. 2010;24(2):343–52.CrossRefPubMed
3.
go back to reference Saito Y, et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc. 2010;72(6):1217–25.CrossRefPubMed Saito Y, et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc. 2010;72(6):1217–25.CrossRefPubMed
4.
go back to reference Pimentel-Nunes P, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2015;47(9):829–54.CrossRefPubMed Pimentel-Nunes P, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2015;47(9):829–54.CrossRefPubMed
5.
go back to reference Chen T, et al. Efficacy and safety of endoscopic submucosal dissection for colorectal Carcinoids. Clin Gastroenterol Hepatol. 2016;14(4):575–81.CrossRefPubMed Chen T, et al. Efficacy and safety of endoscopic submucosal dissection for colorectal Carcinoids. Clin Gastroenterol Hepatol. 2016;14(4):575–81.CrossRefPubMed
7.
go back to reference Terasaki M, et al. Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm. J Gastroenterol Hepatol. 2012;27(4):734–40.CrossRefPubMed Terasaki M, et al. Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm. J Gastroenterol Hepatol. 2012;27(4):734–40.CrossRefPubMed
8.
go back to reference Bosman FT, et al. WHO classification of tumours of the digestive system. Lyon: IARC; 2010. Bosman FT, et al. WHO classification of tumours of the digestive system. Lyon: IARC; 2010.
9.
go back to reference Watanabe T, et al. Japanese Society for Cancer of the colon and Rectum (JSCCR) guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 2015;20(2):207–39.CrossRefPubMedPubMedCentral Watanabe T, et al. Japanese Society for Cancer of the colon and Rectum (JSCCR) guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 2015;20(2):207–39.CrossRefPubMedPubMedCentral
10.
go back to reference Oda I, et al. Treatment strategy after non-curative endoscopic resection of early gastric cancer. Br J Surg. 2008;95(12):1495–500.CrossRefPubMed Oda I, et al. Treatment strategy after non-curative endoscopic resection of early gastric cancer. Br J Surg. 2008;95(12):1495–500.CrossRefPubMed
11.
go back to reference Choi JY, et al. Non-curative endoscopic resection does not always lead to grave outcomes in submucosal invasive early gastric cancer. Surg Endosc. 2015;29(7):1842–9.CrossRefPubMed Choi JY, et al. Non-curative endoscopic resection does not always lead to grave outcomes in submucosal invasive early gastric cancer. Surg Endosc. 2015;29(7):1842–9.CrossRefPubMed
12.
go back to reference Ricciardi R, et al. Population-based analyses of lymph node metastases in colorectal cancer. Clin Gastroenterol Hepatol. 2006;4(12):1522–7.CrossRefPubMed Ricciardi R, et al. Population-based analyses of lymph node metastases in colorectal cancer. Clin Gastroenterol Hepatol. 2006;4(12):1522–7.CrossRefPubMed
13.
go back to reference Bartel MJ, Brahmbhatt BS, Wallace MB. Management of colorectal T1 carcinoma treated by endoscopic resection from the western perspective. Dig Endosc. 2016;28(3):330–41.CrossRefPubMed Bartel MJ, Brahmbhatt BS, Wallace MB. Management of colorectal T1 carcinoma treated by endoscopic resection from the western perspective. Dig Endosc. 2016;28(3):330–41.CrossRefPubMed
14.
go back to reference Kikuchi R, et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38(12):1286–95.CrossRefPubMed Kikuchi R, et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38(12):1286–95.CrossRefPubMed
15.
go back to reference Kim B, et al. The risk of lymph node metastasis makes it unsafe to expand the conventional indications for endoscopic treatment of T1 colorectal cancer: a retrospective study of 428 patients. Medicine (Baltimore). 2016;95(37):e4373.CrossRef Kim B, et al. The risk of lymph node metastasis makes it unsafe to expand the conventional indications for endoscopic treatment of T1 colorectal cancer: a retrospective study of 428 patients. Medicine (Baltimore). 2016;95(37):e4373.CrossRef
Metadata
Title
Efficacy and safety of additional surgery after non-curative endoscopic submucosal dissection for early colorectal cancer
Authors
Tao Chen
Yi-Qun Zhang
Wei-Feng Chen
Ying-Yong Hou
Li-Qing Yao
Yun-Shi Zhong
Mei-Dong Xu
Ping-Hong Zhou
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2017
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-017-0701-y

Other articles of this Issue 1/2017

BMC Gastroenterology 1/2017 Go to the issue