Advanced endoscopic resections in the treatment of malignant colorectal lesions: Are early oncological outcomes impacted?

Am J Surg. 2023 Mar;225(3):537-540. doi: 10.1016/j.amjsurg.2022.11.024. Epub 2022 Nov 23.

Abstract

Background: Limited data exists on the impact of advanced endoscopic resections on early oncological outcomes of malignant colorectal lesions, especially in the presence of perforation.

Methods: Retrospective chart review of patients who underwent advanced endoscopic resections and had adenocarcinoma was performed. The primary endpoint was cancer recurrence.

Results: 63 patients were included. Mean age was 64.6 years with 58.7% of the patients being male. Mean BMI was 30.2 kg/m2 12 patients underwent advanced endoscopic resections followed by surveillance, 5 patients had conversion to surgery due to intra-procedural perforation, and 5 patients due to incomplete resection. 41 patients underwent salvage surgery following a median of 5.4 weeks of initial endoscopic resection. Neither local nor distant recurrence was observed within a median follow-up of 21.2 months.

Conclusion: Advanced endoscopic procedures do not have negative impact on the early oncological outcomes of patients with malignant colorectal lesions, even in the presence of perforation.

Keywords: Cancer recurrence; Early colorectal carcinoma; Early colorectal carcinoma management; Endoscopic submucosal dissection; Malignant polyps; Perforation.

MeSH terms

  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / surgery
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Endoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome