The incremental benefit of dye-based chromoendoscopy to predict the risk of submucosal invasive cancer in large nonpedunculated colorectal polyps

2021 ◽  
Author(s):  
Mayenaaz Sidhu ◽  
Neal Shahidi ◽  
Sergei Vosko ◽  
W. Arnout van Hattem ◽  
David J. Tate ◽  
...  
Keyword(s):  
Colorectal Polyps ◽  
Invasive Cancer ◽  
Incremental Benefit ◽  
Submucosal Invasive Cancer

scholarly journals A121 UNDERWATER EMR FOR NON-LIFTING SESSILE COLORECTAL LESIONS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 102-103
Author(s):  
C Galts ◽  
R Barclay ◽  
D Percy
Keyword(s):  
Surgical Resection ◽  
De Novo ◽  
Lesion Size ◽  
Colorectal Polyps ◽  
Invasive Cancer ◽  
Previous Attempt ◽  
Tubular Adenoma ◽  
En Bloc ◽  
Clinical Role ◽  
Submucosal Injection

Abstract Background Sessile colorectal lesions which do not elevate with submucosal injection — “non-lifting” lesions — are considered poor candidates for EMR due to concerns of possible invasive cancer and increased procedural risk. However, a non-lifting sign is an unreliable predictor of malignancy, relegating many benign lesions to surgical resection. Underwater EMR (UEMR), which obviates submucosal injection, is effective for sessile colorectal polyps but has not been evaluated specifically for non-lifting lesions. Aims The aim of this study was to assess the efficacy of UEMR for “non-lifting” large sessile colorectal lesions with the hypothesis that UEMR may have a clinical role in managing complex lesions. Methods We reviewed our database from 2016 to 2019 for patients referred for large (≥ 20 mm) non-lifting colorectal lesions without overt signs of invasive cancer, who subsequently underwent UEMR. Results Thirty-two cases were successfully treated with single session UEMR. 18 (56%) were de novo lesions whereas the remainder had undergone previous attempt(s) at conventional EMR. The mean lesion size was 37 ± 17 mm. 4 cases (13%) were resected en bloc; the remainder piecemeal. Final pathology was T1 adenocarcinoma, N=3 (9%); tubulovillous adenoma, N=15 (47%); tubular adenoma, N=8 (25%); sessile serrated, N=6 (19%); high-grade dysplasia, N=2 (6%). One patient with cancer underwent surgical resection (T1N0); the remainder had endoscopic follow-up over 8 ± 3 months with benign recurrent/residual lesions in 8%, all amenable to UEMR. There were no procedural complications. Conclusions In this series of large sessile non-lifting colorectal lesions, UEMR was effective for both de novo and previously treated lesions, obviating surgery in the majority of cases. Funding Agencies None

scholarly journals Protocol for a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection: Japan Clinical Oncology Group Study JCOG1612 (RESCUE study)

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e034947
Author(s):  
Tomohiro Kadota ◽  
Hiroaki Ikematsu ◽  
Takeshi Sasaki ◽  
Yutaka Saito ◽  
Masaaki Ito ◽  
...  
Keyword(s):  
High Risk ◽  
Adverse Events ◽  
Clinical Oncology ◽  
Intestinal Resection ◽  
Local Resection ◽  
Invasive Cancer ◽  
Oncology Group ◽  
Japan Clinical Oncology Group ◽  
Adjuvant Chemoradiation ◽  
Submucosal Invasive Cancer

IntroductionIntestinal resection with lymph node dissection is the current standard treatment for high-risk lower rectal submucosal invasive cancer after local resection; however, surgery affects patients’ quality of life due to stoma placement or impaired anal sphincter function. A recent study demonstrated that adjuvant chemoradiation yields promising results.Methods and analysisThis study aims to confirm the non-inferiority of adjuvant chemoradiation, consisting of capecitabine and concurrent radiotherapy (45 Gy in 25 fractions), measured by 5-year relapse-free survival (RFS), over standard surgery in patients with high-risk lower rectal submucosal invasive cancer after local resection. The primary endpoint is 5 year RFS. The secondary endpoints are 10 years RFS, 5-year and 10-year overall survival, 5-year and 10-year local RFS, 5-year and 10-year proportion of anus-preservation without stoma, Wexner score, low anterior resection syndrome score, adverse events and serious adverse events. During the 5-year trial period, 210 patients will be accrued from 65 Japanese institutions.Ethics and disseminationThe National Cancer Center Hospital East Certified Review Board approved this study protocol in October 2018. The study is conducted in accordance with the precepts established in the Declaration of Helsinki and Clinical Trials Act. Written informed consent will be obtained from all eligible patients prior to registration. The primary results of this study will be published in an English article. In addition, the main results will be published on the websites of Japan Clinical Oncology Group (www.jcog.jp) and jRCT (https://jrct.niph.go.jp/). As to data curation, it has not been prepared yet.Trial registration numberjRCT1031180076

Histological factors contributing to a high risk of recurrence of submucosal invasive cancer (pT1) of the colon and rectum after endoscopic therapy

Surgery Today ◽  
2008 ◽  
Vol 38 (8) ◽  
pp. 675-678 ◽  
Author(s):  
Ichiro Nakada ◽  
Takanobu Tabuchi ◽  
Takeshi Nakachi ◽  
Jiro Shimazaki ◽  
Satoru Konishi ◽  
...  
Keyword(s):  
High Risk ◽  
Endoscopic Therapy ◽  
Invasive Cancer ◽  
Risk Of Recurrence ◽  
Colon And Rectum ◽  
Submucosal Invasive Cancer ◽  
Histological Factors

Minute Depressed-Type Submucosal Invasive Cancer-5 mm in Diameter with Intermediate Lymph-Node Metastasis: Report of a Case

2007 ◽  
Vol 50 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Takeshi Nakajima ◽  
Yutaka Saito ◽  
Takahisa Matsuda ◽  
Tatsuhiro Hoshino ◽  
Seiichiro Yamamoto ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Invasive Cancer ◽  
Depressed Type ◽  
Node Metastasis ◽  
Submucosal Invasive Cancer

Sa1593 Risk of Lymph Node Metastasis in Colorectal Submucosal Invasive Cancer: Clinicopathological Differences Between Colonic and Rectal Lesion

2015 ◽  
Vol 81 (5) ◽  
pp. AB274-AB275
Author(s):  
Masayoshi Yamada ◽  
Taku Sakamoto ◽  
Takeshi Nakajima ◽  
Hirokazu Taniguchi ◽  
Shigeki Sekine ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Invasive Cancer ◽  
Node Metastasis ◽  
Rectal Lesion ◽  
Submucosal Invasive Cancer

scholarly journals Optical evaluation: the crux for effective management of colorectal neoplasia

2020 ◽  
Vol 13 ◽  
pp. 175628482092274
Author(s):  
Neal Shahidi ◽  
Sergei Vosko ◽  
W. Arnout van Hattem ◽  
Mayenaaz Sidhu ◽  
Michael J. Bourke
Keyword(s):  
Minimally Invasive ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Mucosal Resection ◽  
Colorectal Neoplasia ◽  
Invasive Cancer ◽  
Depth Of Invasion ◽  
Effective Management ◽  
Mucosal Resection ◽  
Submucosal Dissection ◽  
Submucosal Invasive Cancer

Advances in minimally invasive tissue resection techniques now allow for the majority of early colorectal neoplasia to be managed endoscopically. To optimize their respective risk–benefit profiles, and, therefore, appropriately select between endoscopic mucosal resection, endoscopic submucosal dissection, and surgery, the endoscopist must accurately predict the risk of submucosal invasive cancer and estimate depth of invasion. Herein, we discuss the evidence and our approach for optical evaluation of large (⩾ 20 mm) colorectal laterally spreading lesions.

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