Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection
Background/Aims Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Association for the Study of Intestinal Diseases
2019-01-01
|
| Series: | Intestinal Research |
| Subjects: | |
| Online Access: | http://www.irjournal.org/upload/pdf/ir-2018-00075.pdf |
| _version_ | 1819176898231533568 |
|---|---|
| author | Young-Hoon Jeong Jun Lee Sang-Wook Kim Geom-Seog Seo Hyun-Soo Kim Young-Eun Joo |
| author_facet | Young-Hoon Jeong Jun Lee Sang-Wook Kim Geom-Seog Seo Hyun-Soo Kim Young-Eun Joo |
| author_sort | Young-Hoon Jeong |
| collection | DOAJ |
| description | Background/Aims Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of patients with colorectal laterally spreading tumors (LSTs) that were treated by ESD. Methods The study enrolled all of 210 patients with colorectal LSTs who underwent ESD. Clinical outcomes were analyzed by retrospectively reviewing medical records. Results A cancerous pit pattern (Vi/Vn) was more common in pseudo-depressed (PD) subtype than in flat elevated (FE) subtype. The incidence of adenocarcinoma in the PD subtype and nodular mixed (NM) subtypes was significantly higher than in the homogenous (HG) subtype and FE subtype. The en bloc and R0 resection rates were 89.0% and 85.7%, respectively. The bleeding and perforation rates were 5.2% and 1.9%, respectively. The mean procedure time was much longer in the PD subtype than in the FE subtype. The en bloc resection rate was significantly higher in the NM subtype than in the HG subtype. However, there were no statistically significant differences in mean procedure time, en bloc resection rate, R0 resection rate, bleeding rate, or perforation rate between LST-granular and LST-nongranular types. Conclusions These results indicate that ESD is acceptable for treating colorectal LSTs concerning en bloc resection, curative resection, and risk of complications. Careful consideration is required for complete resection of the PD subtype and NM subtype because of their higher malignant potential. |
| first_indexed | 2024-12-22T21:18:04Z |
| format | Article |
| id | doaj.art-1ee7019a5f634b0faaa756095d317799 |
| institution | Directory Open Access Journal |
| issn | 1598-9100 2288-1956 |
| language | English |
| last_indexed | 2024-12-22T21:18:04Z |
| publishDate | 2019-01-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj.art-1ee7019a5f634b0faaa756095d3177992022-12-21T18:12:17ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562019-01-0117112713410.5217/ir.2018.00075700Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissectionYoung-Hoon Jeong0Jun Lee1Sang-Wook Kim2Geom-Seog Seo3Hyun-Soo Kim4Young-Eun Joo5 Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea Department of Internal Medicine, Chonnam National University Medical School, Gwangju, KoreaBackground/Aims Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of patients with colorectal laterally spreading tumors (LSTs) that were treated by ESD. Methods The study enrolled all of 210 patients with colorectal LSTs who underwent ESD. Clinical outcomes were analyzed by retrospectively reviewing medical records. Results A cancerous pit pattern (Vi/Vn) was more common in pseudo-depressed (PD) subtype than in flat elevated (FE) subtype. The incidence of adenocarcinoma in the PD subtype and nodular mixed (NM) subtypes was significantly higher than in the homogenous (HG) subtype and FE subtype. The en bloc and R0 resection rates were 89.0% and 85.7%, respectively. The bleeding and perforation rates were 5.2% and 1.9%, respectively. The mean procedure time was much longer in the PD subtype than in the FE subtype. The en bloc resection rate was significantly higher in the NM subtype than in the HG subtype. However, there were no statistically significant differences in mean procedure time, en bloc resection rate, R0 resection rate, bleeding rate, or perforation rate between LST-granular and LST-nongranular types. Conclusions These results indicate that ESD is acceptable for treating colorectal LSTs concerning en bloc resection, curative resection, and risk of complications. Careful consideration is required for complete resection of the PD subtype and NM subtype because of their higher malignant potential.http://www.irjournal.org/upload/pdf/ir-2018-00075.pdfColonic neoplasmsEndoscopic submucosal dissectionOutcome |
| spellingShingle | Young-Hoon Jeong Jun Lee Sang-Wook Kim Geom-Seog Seo Hyun-Soo Kim Young-Eun Joo Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection Intestinal Research Colonic neoplasms Endoscopic submucosal dissection Outcome |
| title | Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| title_full | Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| title_fullStr | Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| title_full_unstemmed | Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| title_short | Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| title_sort | clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection |
| topic | Colonic neoplasms Endoscopic submucosal dissection Outcome |
| url | http://www.irjournal.org/upload/pdf/ir-2018-00075.pdf |
| work_keys_str_mv | AT younghoonjeong clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection AT junlee clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection AT sangwookkim clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection AT geomseogseo clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection AT hyunsookim clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection AT youngeunjoo clinicopathologicalfeatureandtreatmentoutcomeofpatientswithcolorectallaterallyspreadingtumorstreatedbyendoscopicsubmucosaldissection |