Early colorectal cancer diagnosed after endoscopic resection: Conservative treatment is safe in most of the cases. Proposal for a risk-based management.

Data de publicació: 01/10/2022

Autors de IIS La Fe

Autors aliens a IIS La Fe

Montesarchio L

Grups d'Investigació

Cirugía digestiva y Cuidados perioperatorios

Leader

Matteo Frasson
Endoscopia Digestiva y Hepática

Leader

Vicente Pons Beltrán

Abstract

INTRODUCTION: Endoscopic resection offers advantages over surgical resection for early colorectal cancer (ECC). However, there might be a presumed risk of recurrence. We aimed to determine the risk of recurrence after endoscopic removal of ECC. METHODS: A single-centre series of endoscopic resections for ECC. Patients were stratified according to four risk factors: positive resection margins, Haggitt 4, lymphatic/vascular invasion and tumour budding. RESULTS: We included 127 patients. Haggitt classification was grade 4 in 54.0%. Positive margins were found in 43 (33.9%), 16 (12.6%) had lymphatic or vascular invasion, and 5 (4.0%) had high grade budding. In 82 (64.5%) endoscopic excision was the definitive treatment, 45 (35.4%) underwent surgery. Six patients (13.3%) had residual tumour on specimen and/or node metastases. Postoperative complications occurred in ten (22.2%). At a median follow-up of 63 months, none of the 82 patients treated with endoscopic resection alone had recurrence. After stratifying patients according to risk factors, those who had residual tumour also had =2 risk factors. CONCLUSIONS: Endoscopic follow up might be a valid option for patients with ECC. A risk-adjusted management seems prudent.

Dades de la publicació

ISSN/ISSNe:: 2173-5077, 2173-5077
Tipus:: Article
Pàgines:: 635-640
DOI:: 10.1016/j.cireng.2022.08.018
PubMed:: 36109115

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Mètriques

Filiacions

Sancho-Muriel J:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Pellino G:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Unit of Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
Cholewa H:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Giner F:: Department of Pathology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Bustamante-Balén M:: Endoscopy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Montesarchio L:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
García-Granero E:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Frasson M:: Colorectal Surgery Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Keywords

Cirugía; Cáncer colorrectal inicial; Early colorectal cancer; Endoscopia; Endoscopy; Factores de riesgo; Haggitt; Polipectomía; Polyp; Polypectomy; Pólipo; Risk factors; Surgery; Tratamiento; Treatment