Year 2020 / Volume 112 / Number 3
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Year 2020 / Volume 112 / Number 3

Original

Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort

172-177

Julia Arribas Anta, Ángel Cañete Ruiz, Teresa Álvarez-Nava Torrego, Carlos Piedracoba-Cadahía, David Rafael de la Cruz Esteban, Marta Rodríguez Carrasco, Esteban Romero Romero, Andrés José del Pozo-García, Sarbelio Rodríguez Muñoz, José Díaz-Tasende, José Carlos Marín-Gabriel,

Introduction: ESD in the colon is an increasingly important technique in Western countries. There are few studies that include long term follow-up. Aim: to analyze the long term recurrence free survival rate after ESD and to compare recurrence rates according to different variables. Methods: this was a prospective observational study of patients with a planned ESD from September 2008 to December 2015. When it was not possible to achieve an ESD, hybrid ESD was performed, either en bloc or piecemeal. Kaplan-Meier survival curves were used to assess the five year local recurrence free survival rate and the recurrence rate. The results were compared according to different factors. Results: of the 89 patients scheduled for ESD who were initially enrolled in the study, 69 were finally included for follow-up. ESD was performed in 31 (45%) patients, KAR in eleven (16%) and pKAR in 27 (39%). The median follow-up was 27 months (range 6-60). The five year disease free survival rate was 81%. The average number of endoscopies needed to eliminate recurrence was two (range 2-7) and no patient required surgery for this reason. The recurrence rate was significantly higher in piecemeal resections vs en bloc resections (27% vs 15%, p = 0.036) and R1 resections vs R0 resections (26% vs 0%, p = 0.034). The presence of affected or unknown lateral margins in en bloc resections without other poor prognosis factors had higher recurrence rates but the difference was not statistically significant (28% vs 0%, p = 0.09). Conclusions: in our study, the five year disease free survival rate was 81% and no patient required surgery during follow-up. Piecemeal and R1 resections had significantly higher recurrence rates, as well as LM involvement, although this was not statistically significant.

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Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2020 The Spanish Journal of Gastroenterology