Complete laparoscopic surgery for early colorectal cancer after endoscopic resection

2013 ◽  
Vol 6 (4) ◽  
pp. 338-341
Author(s):  
Shungo Endo ◽  
Yusuke Takehara ◽  
Jun-ichi Tanaka ◽  
Eiji Hidaka ◽  
Shumpei Mukai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Endoscopic Resection ◽  
Early Colorectal Cancer

scholarly journals Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Ki Ju Kim ◽  
Hyun Seok Lee ◽  
Seong Woo Jeon ◽  
Sun Jin ◽  
Sang Won Lee
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Endoscopic Resection ◽  
Resection Margin ◽  
Residual Disease ◽  
Early Colorectal Cancer ◽  
Residual Cancer ◽  
Mucinous Histology ◽  
Poor Differentiation ◽  
Poorly Differentiated

In the presence of unfavorable pathologic results after endoscopic resection of colorectal cancer, colectomy is routinely performed. We determined the risk factors for residual diseases in patients with colectomy after complete macroscopic endoscopic resection of early colorectal cancer. We identified consecutive patients who underwent endoscopic resection of early colorectal cancer and subsequently underwent colectomy, from January 2011 to December 2014. Clinicopathologic risk factors related to the residual disease were analyzed. In total, 148 patients underwent endoscopic resection and subsequent colectomy. Residual disease on colectomy was noted in 16 (10.9%) patients. The rates of poorly differentiated/mucinous histology (p=0.028) and of positive or unknown vertical resection margin (p=0.047) were higher in patients with residual disease than in those without. In multivariate analysis, a poorly differentiated/mucinous histology and positive or unknown vertical resection margin were significantly associated with residual disease (odds ratio = 7.508 and 2.048, p=0.015 and 0.049, resp.). After complete macroscopic endoscopic resection of early colorectal cancer, there is a greater need for additional colectomy in cases with a positive or unknown vertical resection margin or a poorly differentiated/mucinous histology, because of their higher risk of residual cancer and lymph node metastasis.

Sa1158 Outcomes of Management of Positive Resection Margins After Endoscopic Resection of Early Colorectal Cancer

2016 ◽  
Vol 83 (5) ◽  
pp. AB234-AB235
Author(s):  
Hyun Gun Kim ◽  
Seong-Ran Jeon ◽  
Jun-Hyung Cho ◽  
Bong Min Ko ◽  
Jin Oh Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Early Colorectal Cancer ◽  
Resection Margins ◽  
Positive Resection Margins

Risk of recurrence after endoscopic resection of early colorectal cancer with positive margins

Endoscopy ◽  
2017 ◽  
Vol 50 (03) ◽  
pp. 241-247 ◽  
Author(s):  
Je-Wook Shin ◽  
Kyung Han ◽  
Jong Hyun ◽  
Sang Lee ◽  
Bun Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Resection Margin ◽  
Salvage Surgery ◽  
Positive Margin ◽  
Residual Tumor ◽  
Early Colorectal Cancer ◽  
Clinicopathological Factors ◽  
Positive Resection Margin ◽  
Additional Surgery

Abstract Background and study aim Additional surgery is recommended if an endoscopically resected T1 colorectal cancer (CRC) specimen shows a positive resection margin. We aimed to investigate the significance of a positive resection margin in endoscopically resected T1 CRC. Patients and methods We enrolled 265 patients with T1 CRC who underwent endoscopic resection between January 2001 and December 2016. The inclusion criteria were: 1) complete resection by endoscopy, and 2) pathology of a positive margin. Among the 265 patients, 213 underwent additional surgery and 52 did not. In the additional surgery group, various clinicopathological factors were evaluated with respect to the presence or absence of residual tumor. The follow-up results were assessed in the group that did not undergo additional surgery. Results In the 213 patients who underwent additional surgery, residual tumor was detected in 13 patients (6.1 %), and none of the clinicopathological factors was significantly associated with the presence of residual tumor. Among the 52 patients who did not undergo additional surgery, recurrence was detected in 4 (7.7 %), and all 4 underwent salvage surgery. Among these four patients, three had no risk factors for lymph node metastasis and recurrence was at the previous resection site; pathology was high grade dysplasia, rpT3N0M0, and rpT1N0M0, respectively. Conclusions A positive resection margin in endoscopically resected T1 CRC is related to a relatively low incidence of residual tumor (6.1 %). Although current guidelines recommend additional surgery for such cases, surveillance and timely salvage surgery could be another option in selected cases.

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