Endoscopy 2018; 50(04): S171
DOI: 10.1055/s-0038-1637556
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

OUTCOMES OF ENDOSCOPIC AND SURGICAL REMOVAL OF EARLY COLORECTAL NEOPLASIA

A Fábián
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
R Bor
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
Ö Szabó
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
M Rutka
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
B Vasas
2   University of Szeged, Department of Pathology, Szeged, Hungary
,
L Andrási
3   University of Szeged, Department of Surgery, Szeged, Hungary
,
A Bálint
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
K Farkas
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
Á Milassin
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
K Szántó
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
T Molnár
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
,
Z Szepes
1   University of Szeged, First Department of Internal Medicine, Szeged, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

The best therapeutic approach of early colorectal cancer (CRC) is yet to be defined, and limited data is available on outcomes of endoscopic resection. We aimed to evaluate retrospectively the outcomes of endoscopic and surgical removal of pT1 CRCs between 2012 and 2015 in our tertiary center.

Methods:

Rate of complete pathological resection, lymph node involvement, and local recurrence were assessed as end-points. Mean follow-up period was 28 months.

Results:

90 of the newly diagnosed 1160 CRCs during the study period were pT1 tumors. One patient refused treatment, 33 underwent primary surgical resection with complete tumor removal in 32 cases, and endoscopic resection was attempted in 56 cases based on the endoscopic appearance. According to pathologic reports, complete resection was achieved in 25 cases. Rate of complete resection in case of en bloc and piece meal removal was 56% and 28%, respectively. Similar rates were found in case of pedunculated vs. sessile polyps (53% vs. 28%). Secondary surgery was performed in 14 of the 29 incomplete polypectomy cases (including those with incomplete or uncertain resection margins). Residual tumor was only found in 4 (29%) and lymph node metastasis in 1 case (7%).

Local recurrence was suspected in a total of 14 cases (3 underwent primary, 6 secondary surgery, 5 endoscopic resection without surgery), but none were confirmed by histology. Assessing surgical specimens, nodal involvement was found in 5 cases (11%): 4 underwent primary and 1 secondary surgery. Distant metastasis was revealed in a total of 5 cases (5.6%): 3 underwent prior primary surgery, 2 endoscopic resection without surgery.

Conclusions:

Metastatic potential of pT1 CRCs was similar to literature data. Medium-term outcomes of endoscopic removal with or without secondary surgery were similar to those of primary surgery.