PREDICTIVE FACTORS OF HIDDEN DEEP INFILTRATIVE CARCINOMA IN COLONIC LESIONS DERIVED FOR ENDOSCOPIC MUCOSAL RESECTION

Aims:

Tiny areas of deep infiltrating carcinoma in colorectal lesions can go unnoticed even on detailed examination with chromoendoscopy. Therefore, suspicion of this drawback should be taken into account in decision making. So, it is compulsory needed to determine predictive factors related to deep hidden infiltrating carcinoma (DHIC).

Methods:

Retrospective analysis with a prospective data source of endoscopic mucosal resection database. Univariate and multivariate analysis of the factors associated to DHIC were carried out.

Results:

We assessed 174 lesions (31.72 mm [20 – 120]), 58% located in the proximal colon. In 10/174 (5.74%) DHIC was detected and the patients had to be referred to surgery. In the risk analysis, it was found that: size (>/< 40 mm), location (rectum-sigmoid colon), morphology (0-Is/mixed patterns) and Kudo's Pattern V behaved as independent factors in a univariate analysis (p < 0.01). However, in a multivariate analysis only size > 40 mm [OR 11.40 (p = 0.007)], shape 0-Is [OR = 8.94 (P = 0.02)] and rectosigmoid location [OR 13.50 (P = 0.03)] were noticed as independent risk factors.

Conclusions:

The detection of some or all of these factors might be an effective tool for the prediction of DHIC and therefore serve as support to tailor the therapeutic decision.