Endoscopy 2018; 50(04): S30
DOI: 10.1055/s-0038-1637114
ESGE Days 2018 oral presentations
20.04.2018 – Colon: Improving characterization
Georg Thieme Verlag KG Stuttgart · New York

A POPULATION BASED STUDY OF INTRAMUCOSAL (TIS) COLORECTAL CARCINOMAS DIAGNOSED BETWEEN 2009 AND 2013

J Briant
1   Brest University Hospital, Gastroenterology and Digestive Endoscopy, Brest, France
,
M Cariou
2   Brest University Hospital, Digestive Tumor Registry, Brest, France
3   Universite de Bretagne Occidentale, E.A. SPURBO, Brest, France
,
F Cholet
1   Brest University Hospital, Gastroenterology and Digestive Endoscopy, Brest, France
,
A Billot-Grasset
2   Brest University Hospital, Digestive Tumor Registry, Brest, France
3   Universite de Bretagne Occidentale, E.A. SPURBO, Brest, France
,
L Doucet
4   Brest University Hospital, Dpt of Pathology, Brest, France
,
JB Nousbaum
1   Brest University Hospital, Gastroenterology and Digestive Endoscopy, Brest, France
2   Brest University Hospital, Digestive Tumor Registry, Brest, France
3   Universite de Bretagne Occidentale, E.A. SPURBO, Brest, France
,
M Robaszkiewicz
1   Brest University Hospital, Gastroenterology and Digestive Endoscopy, Brest, France
2   Brest University Hospital, Digestive Tumor Registry, Brest, France
3   Universite de Bretagne Occidentale, E.A. SPURBO, Brest, France
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

The aim of our study was to analyze clinico-pathological characteristics and management of all Tis colorectal adenocarcinomas diagnosed in a population based study between 2009 and 2013.

Methods:

All cases were extracted from the database of the digestive cancer registry. Additional information was obtained from medical records. The variables studied were tumor characteristics, treatment modalities and complications, local and distant recurrence, follow-up modalities and survival.

Results:

478 patients were included, 141 patients (29.5%) were operated on without prior endoscopic treatment and 337 patients (70.5%) were treated with endoscopic resection. Among these patients, 28 underwent a surgical resection after the endoscopic resection (8.3%). The main reasons for the use of first line surgery were the size of the tumor, which was significantly larger in the surgery group than in the endoscopy group (mean size 34.4 mm vs. 18.4 mm), and its location in the right colon (39% vs. 11.3% respectively). Four patients died from complications in the surgery group (2.8%), whereas there was no postoperative death in patients treated with endoscopy. Complications were more frequent in the surgery group than in the endoscopy group (21.3% vs. 15.4%), and surgical management of these complications was also more frequent (5.7% vs. 1.2%). Overall 5-year survival was 75.3% with no significant difference according to the treatment applied. No deaths were related to colorectal cancer; the main causes of death were comorbidities and associated cancers. In univariate analysis, factors significantly associated with poor survival were surgical complications, existence of another cancer, age and gender.

Conclusions:

The results of this study highlight the need for discussion at MDT meetings when there is a doubt about the possibilities of endoscopic resection or in case of incomplete resection. Patient referral to interventional endoscopy centers may limit the use of surgery, which has higher mortality and morbidity than endoscopic treatment.