Outcomes of endoscopic submucosal dissection for treatment of superficial anal squamous cell carcinoma: Multicenter international experience

Abstract

Background and study aims

Data on feasibility of endoscopic submucosal dissection (ESD) for treatment of superficial anal squamous cell carcinoma are limited. This study aimed to evaluate outcomes of ESD in this anatomical location.

Patients and methods

This was a multicenter retrospective study including patients who underwent ESD for treatment of superficial ASCC.

Results

Twenty-three patients with superficial ASCC were included. Median lesion size was 24 mm (range, 9–65 mm) and median procedure time was 62 minutes (range, 26–210 minutes). Accuracy of optical diagnosis using Japanese Endoscopic Society Intrapapillary capillary loops (IPCLs) classification to predict final histology was 63.6%. En bloc and R0 resection were achieved in 22 (95.6%) and 18 patients (78.3%), respectively. The curative resection rate was 73.9% (17/23). Three patients received additional complementary treatment. Delayed bleeding was observed in four patients (17.4%), two of whom required endoscopic hemostasis. Anal pain was reported in nine patients (39.1%) and was effectively managed with analgesics. Fecal incontinence and anal stenosis both occurred in one patient during the perioperative period. During median follow-up of 10.1 months (range, 0–69.6 months), no recurrences were observed.

Conclusions

ESD is a feasible and effective treatment for superficial ASCC. Adverse events were successfully managed with medical or endoscopic therapy. ESD should be considered as first-line resection technique to prevent recurrence while preserving anal sphincter function.

Keywords

Endoscopy Upper GI Tract - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE) - Endoscopic resection (ESD, EMRc, ...) - Endoscopy Lower GI Tract - Endoscopic resection (polypectomy, ESD, EMRc, ...)

Publikationsverlauf

Eingereicht: 08. Januar 2025

Angenommen nach Revision: 18. Juni 2025

Accepted Manuscript online:
23. Juni 2025

Artikel online veröffentlicht:
24. Juli 2025

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