Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance
Abstract Objectives Endoscopic submucosal dissection (ESD) is an effective procedure for the en bloc resection of colorectal neoplasms. However, risk factors for local recurrence after ESD have not been identified. This study aimed to evaluate such risk factors after ESD for colorectal neoplasms. Me...
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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-04-01
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| Online Access: | https://doi.org/10.1002/deo2.269 |
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| author | Taishi Okumura Takemasa Hayashi Shin‐ei Kudo Kenichi Mochizuki Masahiro Abe Tatsuya Sakurai Yuta Kouyama Yushi Ogawa Yasuharu Maeda Naoya Toyoshima Masashi Misawa Toyoki Kudo Kunihiko Wakamura Toshiyuki Baba Fumio Ishida Hideyuki Miyachi |
| author_facet | Taishi Okumura Takemasa Hayashi Shin‐ei Kudo Kenichi Mochizuki Masahiro Abe Tatsuya Sakurai Yuta Kouyama Yushi Ogawa Yasuharu Maeda Naoya Toyoshima Masashi Misawa Toyoki Kudo Kunihiko Wakamura Toshiyuki Baba Fumio Ishida Hideyuki Miyachi |
| author_sort | Taishi Okumura |
| collection | DOAJ |
| description | Abstract Objectives Endoscopic submucosal dissection (ESD) is an effective procedure for the en bloc resection of colorectal neoplasms. However, risk factors for local recurrence after ESD have not been identified. This study aimed to evaluate such risk factors after ESD for colorectal neoplasms. Methods This retrospective study included 1344 patients with 1539 consecutive colorectal lesions who underwent ESD between September 2003 and December 2019. We investigated various factors associated with local recurrence in these patients. The main outcomes were the incidence of local recurrence and its relationship with clinicopathological factors during long‐term surveillance. Results The en bloc resection rate was 98.6%, the R0 resection rate was 97.2%, and the histologically complete resection rate was 92.7%. Local recurrence was observed in 7/1344 (0.5%) patients and the median follow‐up period was 72 months (range 4–195 months). The incidence of local recurrence was significantly higher in lesions ≥40 mm in diameter (hazard ratio [HR] 15.68 [1.88–130.5]; p = 0.011), piecemeal resection (HR 48.42 [10.7–218.7]; p < 0.001), non‐R0 resection (HR 41.05 [9.025–186.7]; p < 0.001), histologically incomplete resection (HR 16.23 [3.627–72.63]; p<0.001), and severe fibrosis (F2; HR 9.523 [1.14–79.3]; p = 0.037). Conclusions Five risk factors for local recurrence after ESD were identified. Patients with such factors should undergo careful surveillance colonoscopy. |
| format | Article |
| id | doaj-art-4e3787e976fb4d94a0591114af02877f |
| institution | Kabale University |
| issn | 2692-4609 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj-art-4e3787e976fb4d94a0591114af02877f2025-08-20T03:41:00ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.269Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillanceTaishi Okumura0Takemasa Hayashi1Shin‐ei Kudo2Kenichi Mochizuki3Masahiro Abe4Tatsuya Sakurai5Yuta Kouyama6Yushi Ogawa7Yasuharu Maeda8Naoya Toyoshima9Masashi Misawa10Toyoki Kudo11Kunihiko Wakamura12Toshiyuki Baba13Fumio Ishida14Hideyuki Miyachi15Digestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanDigestive Disease Center Showa University Northern Yokohama Hospital KanagawaJapanAbstract Objectives Endoscopic submucosal dissection (ESD) is an effective procedure for the en bloc resection of colorectal neoplasms. However, risk factors for local recurrence after ESD have not been identified. This study aimed to evaluate such risk factors after ESD for colorectal neoplasms. Methods This retrospective study included 1344 patients with 1539 consecutive colorectal lesions who underwent ESD between September 2003 and December 2019. We investigated various factors associated with local recurrence in these patients. The main outcomes were the incidence of local recurrence and its relationship with clinicopathological factors during long‐term surveillance. Results The en bloc resection rate was 98.6%, the R0 resection rate was 97.2%, and the histologically complete resection rate was 92.7%. Local recurrence was observed in 7/1344 (0.5%) patients and the median follow‐up period was 72 months (range 4–195 months). The incidence of local recurrence was significantly higher in lesions ≥40 mm in diameter (hazard ratio [HR] 15.68 [1.88–130.5]; p = 0.011), piecemeal resection (HR 48.42 [10.7–218.7]; p < 0.001), non‐R0 resection (HR 41.05 [9.025–186.7]; p < 0.001), histologically incomplete resection (HR 16.23 [3.627–72.63]; p<0.001), and severe fibrosis (F2; HR 9.523 [1.14–79.3]; p = 0.037). Conclusions Five risk factors for local recurrence after ESD were identified. Patients with such factors should undergo careful surveillance colonoscopy.https://doi.org/10.1002/deo2.269endoscopic submucosal dissectionlocal recurrencenon‐R0 resectionrisk factorssurveillance colonoscopy |
| spellingShingle | Taishi Okumura Takemasa Hayashi Shin‐ei Kudo Kenichi Mochizuki Masahiro Abe Tatsuya Sakurai Yuta Kouyama Yushi Ogawa Yasuharu Maeda Naoya Toyoshima Masashi Misawa Toyoki Kudo Kunihiko Wakamura Toshiyuki Baba Fumio Ishida Hideyuki Miyachi Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance DEN Open endoscopic submucosal dissection local recurrence non‐R0 resection risk factors surveillance colonoscopy |
| title | Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance |
| title_full | Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance |
| title_fullStr | Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance |
| title_full_unstemmed | Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance |
| title_short | Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance |
| title_sort | endoscopic submucosal dissection for colorectal neoplasms risk factors for local recurrence and long term surveillance |
| topic | endoscopic submucosal dissection local recurrence non‐R0 resection risk factors surveillance colonoscopy |
| url | https://doi.org/10.1002/deo2.269 |
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