ENDOSCOPIC FULL-THICKNESS RESECTION (EFTR) FOR EARLY COLORECTAL CARCINOMA (CRC) – A RETROSPECTIVE ANALYSIS OF 31 CONSECUTIVE CASES

Aims EFTR has an emerging role in the resection of early CRC with low-risk histological features. We aimed to access the efficacy, safety and oncologic follow-up of patients with early CRC treated with eFTR.

Methods Single-center retrospective analysis of all patients with early CRC treated with eFTR from 11/2016 – 11/2021.

Results Of the 106 eFTR performed in our endoscopy department, 31 patients with early CRC (12 women, mean age 72) were found. The 22 colon and 9 rectal lesions could all be reached; mean histologic lesion size was 13,7 mm (3-25 mm). Mean procedure time was 47,3 min (25-70 min). Technically successful resection and histological R0 resection was achieved in 93,5% and 67,7% of cases, respectively. In 9/31 patients with previously incompletely resected CRCs (R1/Rx) no residual cancer was histologically found after eFTR. 4/31 patients had low-risk features, of which one patient underwent oncologic resection (R1 at lateral margin). 18/31 patients had high-risk features (2 T2, 7 sm2-3±L1, 9 R1), of which only 8 patients underwent an oncological surgery. Over a median follow-up period of 15.5 months (0-47), one patient died from cardiac cause and one patient who previously underwent surgery experienced a tumor recurrence (liver metastasis). Adverse events included 2 minor bleedings, one ileus, which could be managed conservatively, and two perforations, which could be closed endoscopically with an over-the-scope clip.

Conclusions eFTR allows accurate histological risk assessment, which may spare patients with early CRC an oncologic surgery. Prospective studies with appropriate oncologic follow-up are needed to evaluate long-term efficacy.

Publication History

Article published online:
14 April 2022