| Theme |
Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma |
| Title |
Clinicopathological characteristics of recurrent lesions after endoscopic submucosal dissection for laterally spreading tumors: A single-center experience |
| Author |
Masayoshi Yamada |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Hiroyuki Takamaru |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Taku Sakamoto |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Yutaka Saito |
Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] |
Removal of laterally spreading tumors using endoscopic submucosal dissection (ESD) has been reported to clearly contribute to a decrease in local recurrences compared with conventional endoscopic mucosal resection (EMR). On the other hand, it is also argued that if metastatic recurrence is detected after ESD, salvage is difficult. Currently, if only tumor depth of invasion is a non-curative factor, the possibility of expansion of ESD indications has been studied based on the risk of lymph node metastasis of surgical resected specimens. However, sufficient evidence has not been obtained yet. From the clinicopathological characteristics of recurrent cases in our hospital, most of the recurred cases of invasive cancer, had developed distant metastases and their clinical prognoses were poor. Therefore, additional surgery for curative intent is the standard strategy at the present, when non-curative factors other than lateral cut margins are positive in the pathological findings of the ESD resected specimen. In the near future, factors predicting an invasive recurrence after ESD will be clarified in detail and taking care of patients' general conditions will be demanding. |