Endoscopic full-thickness resection for early colorectal cancer
| Autor: | I. Wallstabe, Benjamin Meier, Armin Kuellmer, Claus Schäfer, Christopher Hofmann, Andreas Erhardt, Anne Glitsch, Arthur Schmidt, Karel Caca, Robert Thimme, Julius Mueller, David Albers, Brigitte Schumacher, Dominik Bettinger, Patrick Aepli |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer business.industry Gastroenterology Medizin Retrospective cohort study Subgroup analysis medicine.disease 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Cohort medicine Adenocarcinoma 030211 gastroenterology & hepatology Radiology Nuclear Medicine and imaging Radiology business Adverse effect Prospective cohort study Risk assessment |
| Popis: | Background and Aims Current international guidelines recommend endoscopic resection for T1 colorectal cancer (CRC) with low-risk histology features and oncologic resection for those at high risk of lymphatic metastasis. Exact risk stratification is therefore crucial to avoid under-treatment as well as over-treatment. Endoscopic full-thickness resection (EFTR) has shown to be effective for treatment of non-lifting benign lesions. In this multicenter, retrospective study we aimed to evaluate efficacy, safety, and clinical value of EFTR for early CRC. Methods Records of 1234 patients undergoing EFTR for various indications at 96 centers were screened for eligibility. A total of 156 patients with histologic evidence of adenocarcinoma were identified. This cohort included 64 cases undergoing EFTR after incomplete resection of a malignant polyp (group 1) and 92 non-lifting lesions (group 2). Endpoints of the study were: technical success, R0-resection, adverse events, and successful discrimination of high-risk versus low-risk tumors. Results Technical success was achieved in 144 out of 156 (92.3%). Mean procedural time was 42 minutes. R0 resection was achieved in 112 of 156 (71.8%). Subgroup analysis showed a R0 resection rate of 87.5% in Group 1 and 60.9% in Group 2 (P Conclusions In early colorectal cancer, EFTR is technically feasible and safe. It allows exact histological risk stratification and can avoid surgery for low-risk lesions. Prospective studies are required to further define indications for EFTR in malignant colorectal lesions and to evaluate long-term outcome. |
| Databáze: | OpenAIRE |
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