Combining Endoscopic Submucosal Dissection and Adjuvant Chemoradiotherapy or Radiotherapy for Effective Management of Rectal Cancer with Deep Submucosal Invasion: A Case Series

Korean J Gastroenterol. 2024 Nov 25;84(5):230-234. doi: 10.4166/kjg.2024.088.

Abstract

Rectal cancer is one of the most prevalent malignancies worldwide, and the introduction of an endoscopic submucosal dissection (ESD) has offered minimally invasive management for early colorectal cancers. On the other hand, a post-ESD pathological examination showed that the risk of lymph node metastasis increases with deep submucosal (SM) invasion, positive lymphovascular invasion, grade 2/3 tumor budding, and certain histological types. An intestinal resection with a lymph node dissection is recommended in these cases, and chemoradiotherapy (CRT) is also effective adjuvant therapy. This paper reports a case series of patients who underwent ESD for rectal cancer and received concurrent CRT because of pathologically confirmed deep SM invasion.

Keywords: Chemoradiotherapy; Endoscopic mucosal resection; Rectal neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chemoradiotherapy, Adjuvant*
  • Colonoscopy
  • Endoscopic Mucosal Resection*
  • Female
  • Humans
  • Intestinal Mucosa / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / therapy
  • Tomography, X-Ray Computed