Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas

Abstract

Background/AimsThe efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.MethodsAmong patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.ResultsOverall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.ConclusionsCautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma

“…In this study, we did not find any CRCs during a subsequent follow-up colonoscopy, which may be probably because of early endoscopic detection and resection of SSAs/APs as previously reported in the study by Seo et al 32 It may also have been because the number of patients included in this study was small, and the follow-up period was relatively shorter than that in other studies.…”

Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program

“…As SSLs have been established as precursors of colorectal cancer via the serrated neoplasia pathway, endoscopists should be trained to recognize and resect SSLs during colonoscopy. [24][25][26] In this study, the WASP classification showed a superior performance in reaching the PIVI thresholds with the incorporation of the optical diagnosis of SSLs. Using WASP classification showed a significant overall increase in the optical diagnosis of SSLs over time but a relatively lower sensitivity and longer learning curves compared with ADs (Supplementary Table 3).…”

Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages

“…Worldwide, in 2012, more than 1.3 million people were newly diagnosed with colorectal cancer (CRC), and nearly 0.7 million died of the disease . Colonoscopy is recommended as one of the methods for CRC screening and allows for removal of premalignant lesions as well as early detection of cancer during a single procedure . Screening colonoscopy is associated with an approximately half reduction in the incidence and two‐thirds reduction in mortality from CRC .…”

“…1 Colonoscopy is recommended as one of the methods for CRC screening and allows for removal of premalignant lesions as well as early detection of cancer during a single procedure. [2][3][4] Screening colonoscopy is associated with an approximately half reduction in the incidence and two-thirds reduction in mortality from CRC. 5,6 However, limited resources and low adherence have been major obstacles for the implementation of CRC screening.…”