| Theme | "Early Colorectal Cancer" and "Intestine", Road to future | |
|---|---|---|
| Title | Present and future endoscopic treatments for colorectal tumors | |
| Publish Date | 2016/01 | |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| Author | Masayoshi Yamada | Endoscopy Division, National Cancer Center Hospital |
| Author | Hiroyuki Takamaru | Endoscopy Division, National Cancer Center Hospital |
| Author | Hirohito Tanaka | Endoscopy Division, National Cancer Center Hospital |
| Author | Kazuya Inoki | Endoscopy Division, National Cancer Center Hospital |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] | Colonoscopy is a proven, valuable method to reduce not only colorectal cancer morbidity but also colorectal cancer deaths. However, low participation rates for screening are a major problem in Japan. Magnified image-enhanced endoscopy techniques such as Narrow Band Imaging (NBI) and Auto-Fluorescence Imaging (AFI) are effective for determination of cancer invasion depth. Endoscopic mucosal resection (EMR) has been the gold standard technique for endoscopic treatment of early colorectal cancer. However, colorectal endoscopic submucosal dissection (ESD) has also been approved for insurance coverage by the National Health Insurance system since April 2012. It is widely used for early colorectal cancer >2 cm in diameter when conventional EMR treatment would be difficult. ESD is, however, still difficult for western endoscopists to perform. Therefore, further development of safe, effective endoscopic resection techniques is anticipated. In the future, the clinical usefulness of chemo-radiotherapy may be explored, especially for rectal lesions post resection for T1 cancer, while considering patients' QOL and possible curability. |
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