دورية أكاديمية
Risk of residual neoplasia after a noncurative colorectal endoscopic submucosal dissection for malignant lesions: a multinational study.
| العنوان: | Risk of residual neoplasia after a noncurative colorectal endoscopic submucosal dissection for malignant lesions: a multinational study. |
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| المؤلفون: | Santos-Antunes J; Gastroenterology Department, Faculty of Medicine, Centro Hospitalar Universitário S. João, Porto, Portugal.; Ipatimup/i3S (Instituto de Investigação e Inovação em Saúde da Universidade do Porto), Porto, Portugal., Pioche M; Department of Hepatology and Gastroenterology, Edouard Herriot Hospital, Lyon, France., Ramos-Zabala F; Department of Gastroenterology, Department of Clinical Medical Sciences, Hospital Universitario HM Montepríncipe, HM Hospitales, Universidad San Pablo-CEU, CEU Universities Madrid, Madrid, Spain., Cecinato P; Gastroenterology and Digestive Endoscopy Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy., Gallego Rojo FJ; Gastroenterology Department, Hospital de Poniente, Almería, Spain., Barreiro P; Gastroenterology Department, Centro Hospitalar Lisboa Ocidental EPE, Lisbon, Portugal.; Lisbon Advanced Endoscopic Center, Hospital Lusíadas, Lisbon, Portugal., Félix C; Gastroenterology Department, Centro Hospitalar Lisboa Ocidental EPE, Lisbon, Portugal., Sferrazza S; Gastroenterology and Endoscopy Unit, Santa Chiara Hospital, Trento, Italy., Berr F; Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria., Wagner A; Department of Internal Medicine I, University Clinics Salzburg, Paracelsus Medical University, Salzburg, Austria., Lemmers A; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium., Figueiredo Ferreira M; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium., Albéniz E; Navarrabiomed Research Institute, Complejo Hospitalario de Navarra, Public University of Navarra, IdiSNA, Pamplona, Spain., Uchima H; Digestive Endoscopy Service, Centro Médico Teknon, Barcelona, Spain.; Gastroenterology Service, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain., Küttner-Magalhães R; Gastroenterology Department, Hospital Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal., Fernandes C; Gastroenterology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Morais R; Gastroenterology Department, Faculty of Medicine, Centro Hospitalar Universitário S. João, Porto, Portugal., Gupta S; Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia., Martinho-Dias D; Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal., Rios E; Pathology Department, Faculty of Medicine, Centro Hospitalar Universitário S. João, Porto, Portugal., Faria-Ramos I; Ipatimup/i3S (Instituto de Investigação e Inovação em Saúde da Universidade do Porto), Porto, Portugal., Marques M; Gastroenterology Department, Faculty of Medicine, Centro Hospitalar Universitário S. João, Porto, Portugal., Bourke MJ; Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia., Macedo G; Gastroenterology Department, Faculty of Medicine, Centro Hospitalar Universitário S. João, Porto, Portugal. |
| المصدر: | Endoscopy [Endoscopy] 2023 Mar; Vol. 55 (3), pp. 235-244. Date of Electronic Publication: 2022 Jul 21. |
| نوع المنشور: | Multicenter Study; Clinical Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Georg Thieme Verlag Country of Publication: Germany NLM ID: 0215166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1438-8812 (Electronic) Linking ISSN: 0013726X NLM ISO Abbreviation: Endoscopy Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Stuttgart : Georg Thieme Verlag Original Publication: Stuttgart, Thieme. |
| مواضيع طبية MeSH: | Endoscopic Mucosal Resection*/adverse effects , Endoscopic Mucosal Resection*/methods , Colorectal Neoplasms*/surgery , Colorectal Neoplasms*/pathology, Humans ; Lymphatic Metastasis ; Endoscopy ; Retrospective Studies ; Neoplasm, Residual ; Treatment Outcome |
| مستخلص: | BACKGROUND : Endoscopic submucosal dissection (ESD) in colorectal lesions is technically demanding and a significant rate of noncurative procedures is expected. We aimed to assess the rate of residual lesions after a noncurative ESD for colorectal cancer (CRC) and to establish predictive scores to be applied in the clinical setting. METHODS : Retrospective multicenter analysis of consecutive colorectal ESDs. Patients with noncurative ESDs performed for the treatment of CRC lesions submitted to complementary surgery or with at least one follow-up endoscopy were included. RESULTS : From 2255 colorectal ESDs, 381 (17 %) were noncurative, and 135 of these were performed in CRC lesions. A residual lesion was observed in 24 patients (18 %). Surgery was performed in 96 patients and 76 (79 %) had no residual lesion in the colorectal wall or in the lymph nodes. The residual lesion rate for sm1 cancers was 0 %, and for > sm1 cancers was also 0 % if no other risk factors were present. Independent risk factors for lymph node metastasis were poor differentiation and lymphatic permeation (NC-Lymph score). Risk factors for the presence of a residual lesion in the wall were piecemeal resection, poor differentiation, and positive/indeterminate vertical margin (NC-Wall score). CONCLUSIONS : Lymphatic permeation or poor differentiation warrant surgery owing to their high risk of lymph node metastasis, mainly in > sm1 cancers. In the remaining cases, en bloc and R0 resections resulted in a low risk of residual lesions in the wall. Our scores can be a useful tool for the management of patients who undergo noncurative colorectal ESDs. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.) |
| التعليقات: | Comment in: Endoscopy. 2023 Mar;55(3):252-254. (PMID: 36630975) Comment in: Endoscopy. 2023 Sep;55(9):881-882. (PMID: 37643603) |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04484311 |
| تواريخ الأحداث: | Date Created: 20220721 Date Completed: 20230302 Latest Revision: 20231011 |
| رمز التحديث: | 20231011 |
| DOI: | 10.1055/a-1906-8000 |
| PMID: | 35863354 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1438-8812 |
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| DOI: | 10.1055/a-1906-8000 |