Year 2020 / Volume 112 / Number 3
Original
Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort

172-177

DOI: 10.17235/reed.2020.6268/2019

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,

Abstract
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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References
1 - Tanaka S, Oka S, Chayama K. Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection. J Gastroenterol 2008;43(9): 641-51
2 - Tanaka S, Kashida H, Saito Y, et al. JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 2015; 27(4):417-34
3 - Neuhaus H. ESD around the world: Europe. Gastrointest Endosc Clin N Am 2014; 24(2):295-31
4 - Fuccio L, Hassan C, Ponchon T, et al. Clinical outcomes after endoscopic submucosal dissection for colorectal neoplasia: a systematic review and meta-analysis. Gastrointest Endosc 2017 86(1):74-86
5 - Bhattacharyya R, Chedgy FJ, Kandiah K, et al. Knife-assisted snare resection (KAR) of large and refractory colonic polyps at a Western centre: feasibility, safety and efficacy study to guide future practice. United European Gastroenterol J 2016; 4(3):466-73
6 - The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003; 58(6 Suppl):S3-43.
7 - Kudo S, Lambert R, Allen JI, et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 2008; 68(4 Suppl):S3-47.
8 - Schlemper RJ, Riddell RH, Kato Y, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut 2000; 47(2):251-5.
9 - Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47(9):829-54.
10 - Kudo S, Hirota S, Nakajima T, et al. Colorectal tumours and pit pattern. J Clin Pathol. 1994; 47:880–885
11 - Hulagu S, Senturk O, Aygun C, et al. Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers. World J Gastroenterol 2011; 17(13):1701-9
12 - Milano R, Viale E, Bartel MJ, et al. Resection outcomes and recurrence rates of endoscopic submucosal dissection (ESD) and hybrid ESD for colorectal tumors in a single Italian center. Surg Endosc 2018; 32:2328–2339
13 - Barthel MJ, Bhaumik S, Brahmbhatt S, et al. Management of colorectal T1 carcinoma treated by endoscopic resection from the western perspective. Dig endosc 2016; 28(3): 330-341
14 - Yamada M, Saito Y, Takamaru H, et al. Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy 2017; 49 (3) 233-242
15 - Toyonaga, T., Man-i M, East, J.E, et al. 1,635 Endoscopic submucosal dissection cases in the esophagus, stomach, and colorectum: complication rates and long-term outcomes. Surg Endosc 2013; 27 (3): 1000-8
16 - Shigita S, Oka S, Tanaka S, et al. Long-term outcomes after endoscopic submucosal dissection for superficial colorectal tumors. Gastrointest Endosc 2017; 85(3):546-553
17 - Repici A, Hassan C, De Paula Pessoa D, et al. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 2012; 44(2):137-50.
18 - Saito Y, Kawano H, Takeuchi Y, et al. Current status of colorectal endoscopic submucosal dissection in Japan and other Asian countries: progressing towards technical standardization. Dig Endosc 2012; 24 Suppl 1:67-72
19 - Uraoka T, Parra-Blanco A, Yahagi N, et al. Colorectal endoscopic submucosal dissection: is it suitable in western countries? J Gastroenterol Hepatol 2013; 28(3):406-14
20 - Patel N, Patel K, Ashrafian H, et al. Colorectal endoscopic submucosal dissection: Systematic review of mid-term clinical outcomes. Dig Endosc 2016 28(4):405-416
21 - Probst A, Golger D, Anthuber M, et al. Endoscopic submucosal dissection in large sessile lesions of the rectosigmoid: learning curve in a European Centre. Endoscopy 2012; 44(7):660-7
22 - Lee EJ, Lee JB, Lee, et al. Endoscopic submucosal dissection for colorectal tumors--1,000 colorectal ESD cases: one specialized institute's experiences. Surg Endosc 2013, 27 (1) 31-9
23 - Marín Gabriel JC, Lora-Pablos D, Díaz Tasende J, et al. Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: a preoperative risk score from the beginning. Rev Esp Enferm Dig 2018; 110(11) 699-705
24 - Saito Y, Uraoka T, Yamaguchi Y. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections. Gastrointest Endosc 2010; 72: 1217-25
25 - Fuccio L, Repici A, Hassan C. Why attempt en bloc resection of non-pedunculated colorectal adenomas? A systematic review of the prevalence of superficial submucosal invasive cancer after endoscopic submucosal dissection. Gut 2018; 67(8) : 1464-74
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Arribas Anta J, Cañete Ruiz Á, Álvarez-Nava Torrego T, Piedracoba-Cadahía C, Rafael de la Cruz Esteban D, Rodríguez Carrasco M, et all. Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort. 6268/2019


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Publication history

Received: 07/03/2019

Accepted: 02/01/2020

Online First: 14/02/2020

Published: 05/03/2020

Article revision time: 297 days

Article Online First time: 344 days

Article editing time: 364 days


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