| Theme |
Forefront of endoscopic treatment in early colorectal cancer |
| Title |
Feasibility of re-endoscopic resection for remnant or recurrent colorectal tumor after endoscopic mucosal resections for laterally spreading tumors |
| Author |
Hirohisa Machida |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Yasushi Sano |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Hikaru Kuwamura |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Kiyomi Mera |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Hisashi Endo |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Toshihiko Doi |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Takahiro Fujii |
Fujii Takahiro Clinic |
| Author |
Shigeaki Yoshida |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| [ Summary ] |
From July 1992 to March 2003, 392 laterally spreading tumors (LSTs) of the colorectum were removed endoscopically (endoscopic resection ; EMR) in the National Cancer Center Hospital East. A total of 310 lesions (79.1%), received follow-ups over a greater than three month, period.
The incidence of remnant or recurrent tumor amounted to 8.7% (27 lesions), and showed a tendency to be frequent in lesions after piecemeal resection (p<0.001). Above all, they occurred frequently in the cecum. Twenty six out of twenty seven tumors were managed successfully with repeated local treatment using re-EMR, polypectomy or Argon plasma coagulation. With the other lesion, surgical resection was performed, because local recurrence was diagnosed as advanced cancer. The median time to detect remnant or recurrent tumors was 6.2 months. Eleven out of thirteen tumors, which were detected at the time of first surveillance examination within 6 months after first EMR, were seen to be in post EMR status after piecemeal resection. On the other hand, two of them were detected more than 30 months after first EMR. These figures may suggest that follow up examinations 3-6 months after the first EMR are useful for surveillance examinations after piecemeal resection for LSTs, as well as for long time follow-up examination. On the basis of these results concerning endoscopic treatment, remnant or recurrent colorectal tumors after EMR may be controllable with repeated local treatment. Nevertheless, the incidence of this condition amounts to 8.7% of patients. |