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Long-term prognosis of curative endoscopic submucosal dissection for early colorectal cancer according to submucosal invasion: a multicenter cohort studyopen access

Authors
Shin, JongbeomKim, Eun RanJang, Hyun JooBaek, Dong HoonYang, Dong-HoonLee, Bo-InCho, Kwang BumCho, Jin WoongJung, Sung-AeHong, Su JinKo, Bong Min
Issue Date
Sep-2022
Publisher
BioMed Central
Keywords
Early colorectal cancer; Endoscopic submucosal dissection; Recurrence free survival
Citation
BMC Gastroenterology, v.22, no.1, pp 417
Journal Title
BMC Gastroenterology
Volume
22
Number
1
Start Page
417
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21448
DOI
10.1186/s12876-022-02499-0
ISSN
1471-230X
Abstract
Background Endoscopic submucosal dissection (ESD) can provide a high en bloc resection rate and has been widely applied as curative treatment for early colorectal cancer (ECC). However, surgical treatment is occasionally required, and reports on the long-term prognosis of ESD are insufficient. This study aimed to investigate the long-term outcomes of ECC removal by ESD, including local recurrence and metastasis. Methods This multicenter study was conducted retrospectively on 450 consecutive patients with ECC who were treated with ESD between November 2003 and December 2013. Clinical, pathological, and endoscopic data were collected to determine tumor depth, resection margin, lymphovascular invasion, and recurrence. Results The median follow-up period was 53.8 (12-138 months). The en bloc resection rate was 85.3% (384) and in intramucosal cancer being 84.1% and in superficial submucosal invasion (SM1) cancer being 89.8% (p = 0.158). The curative resection rate was 76.0% (n = 342), and there was no statistical difference between the two groups (77.3% vs. 71.4%, p = 0.231). The overall recurrence free survival rate (RFS) was 98.7% (444/450). In patients with curative resection, there was no statistically significant difference in RFS according to invasion depth (intramucosal: 99.3% vs. SM1: 97.1%, p = 0.248). Conclusions Patients with curatively resected ECC treated with ESD showed favorable long-term outcomes. Curatively resected SM1 cancer has a RFS similar to that of intramucosal cancer.
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