Endoscopic resection for submucosally invasive colorectal cancer

Abstract

Preoperative endoscopic resection for colorectal submucosal cancer is feasible, provided the resection is complete. The indications for surgical treatment should be determined after pathologic examination.

Oncological outcomes after endoscopic removal of malignant colorectal polyps

“…However, whether the requisite distance should be > 1, > 2, or > 3 mm or only a clear margin is still under debate (21,(25)(26)(27). In our analysis we found a 25 % rate of local wall disease and the margin status showed to be an independent risk factor for that, mostly in sessile lesions that are our main group, in agreement with earlier studies as Hassan et al pointed out (22,28,29). Polyp configuration, differentiation and margin status were also statistically relevant for wall disease.…”

Histologic Risk Factors and Clinical Outcome in Colorectal Malignant Polyp: A Pooled-Data Analysis

“…Regarding endoscopic data, polyp site was clearly specified in 17 series, accounting for 1,461 polyps. 14,[20][21][22]24,26,27,29,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]39 In such studies, the rectum was involved in 19.6 percent of the cases, the left colon in 71 percent, and the right colon in the remaining 9.4 percent. Polyp morphology was available in 19 series, enrolling 1,145 polyps.…”

“…Death because of surgical complications, inferred from 28 studies, was reported in 8 (0.8 percent) of 951 operated patients. [12][13][14][15][16][17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41][42] …”

“…[12][13][14][16][17][18][19]21,[27][28][29][30][31][32][33][34]37,[40][41][42] According to our protocol, the resection margin was reported to be positive in 325 (33.2 percent) and negative in the remaining 655 (66.8 percent) cases. In those studies for which polyp morphology also could be inferred, a positive resection margin was significantly more frequent in sessile (25/44) than in pedunculated (34/182) polyps (56.8 vs. 18.7 percent; P < 0.0001).…”

“…[12][13][14]16,[18][19][20][21][22][23]25,26,[28][29][30][31]33,35,39,[40][41][42] This risk factor tended to be more frequent in sessile (30/214) compared with pedunculated (30/327) polyps (14 vs. 9.2 percent, respectively; P = 0.08). 12,20,21,26,28,33,35 Lymph node metastasis was much more common in polyps with such a risk factor than in those without it, whereas no substantial difference in residual disease, hematogenous metastasis, or cancer-related mortality was detected (Table 1).…”