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Multicenter Study
. 2022 Sep 13;22(1):417.
doi: 10.1186/s12876-022-02499-0.

Long-term prognosis of curative endoscopic submucosal dissection for early colorectal cancer according to submucosal invasion: a multicenter cohort study

Jongbeom Shin  1 , Eun Ran Kim #  2 , Hyun Joo Jang  3 , Dong Hoon Baek  4 , Dong-Hoon Yang  5 , Bo-In Lee  6 , Kwang Bum Cho  7 , Jin Woong Cho  8 , Sung-Ae Jung  9 , Su Jin Hong  10 , Bong Min Ko #  11 ; Research Group for Endoscopic Submucosal Dissection in Korean Society of Gastrointestinal Endoscopy
Collaborators, Affiliations
Multicenter Study

Long-term prognosis of curative endoscopic submucosal dissection for early colorectal cancer according to submucosal invasion: a multicenter cohort study

Jongbeom Shin et al. BMC Gastroenterol. .

Abstract

Background: Endoscopic submucosal dissection (ESD) can provide a high en bloc resection rate and has been widely applied as curative treatment for early colorectal cancer (ECC). However, surgical treatment is occasionally required, and reports on the long-term prognosis of ESD are insufficient. This study aimed to investigate the long-term outcomes of ECC removal by ESD, including local recurrence and metastasis.

Methods: This multicenter study was conducted retrospectively on 450 consecutive patients with ECC who were treated with ESD between November 2003 and December 2013. Clinical, pathological, and endoscopic data were collected to determine tumor depth, resection margin, lymphovascular invasion, and recurrence.

Results: The median follow-up period was 53.8 (12-138 months). The en bloc resection rate was 85.3% (384) and in intramucosal cancer being 84.1% and in superficial submucosal invasion (SM1) cancer being 89.8% (p = 0.158). The curative resection rate was 76.0% (n = 342), and there was no statistical difference between the two groups (77.3% vs. 71.4%, p = 0.231). The overall recurrence free survival rate (RFS) was 98.7% (444/450). In patients with curative resection, there was no statistically significant difference in RFS according to invasion depth (intramucosal: 99.3% vs. SM1: 97.1%, p = 0.248).

Conclusions: Patients with curatively resected ECC treated with ESD showed favorable long-term outcomes. Curatively resected SM1 cancer has a RFS similar to that of intramucosal cancer.

Keywords: Early colorectal cancer; Endoscopic submucosal dissection; Recurrence free survival.

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Conflict of interest statement

All authors declare that they have no conflicts of interest related to this study.

Figures

Fig. 1
Fig. 1
Patient selection flowchart. Abbreviations: ESD endoscopic submucosal dissection, ECC early colorectal cancer, SM submucosa, PM proper muscle
Fig. 2
Fig. 2
Kaplan–Meier curves demonstrating cumulative recurrence free survival rates in A overall enrolled ECC patients and B according to depth of cancer invasion
Fig. 3
Fig. 3
Kaplan–Meier curves demonstrating cumulative recurrence free survival rates A in curatively resected ECC patients and B according to depth in curatively resected patients
See this image and copyright information in PMC

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