Outcome of salvage surgery for colorectal cancer initially treated by upfront endoscopic therapy

Surgery ◽  
2016 ◽  
Vol 159 (3) ◽  
pp. 713-720 ◽  
Author(s):  
Hiroaki Nozawa ◽  
Soichiro Ishihara ◽  
Mitsuhiro Fujishiro ◽  
Shinya Kodashima ◽  
Kensuke Ohtani ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Therapy ◽  
Salvage Surgery

Incidence of methacronous cancer after total colectomy with ileorectal anastomosis or total proctocolectomy in classical FAP patients.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 646-646
Author(s):  
Samuel Aguiar ◽  
Paulo Roberto Stevanato ◽  
Fabio Oliveira Ferreira ◽  
Erika Maria Monteiro Santos ◽  
Ranyell Spencer Sobreira Batista ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ileal Pouch ◽  
Ileorectal Anastomosis ◽  
Total Colectomy ◽  
Salvage Surgery ◽  
Dentate Line ◽  
Hereditary Colorectal Cancer ◽  
Total Proctocolectomy ◽  
Adenomatous Polyposis ◽  
Rectal Anastomosis

646 Background: Total proctocolectomy (TPC) with ileal pouch is considered the procedure of choice in classic familial adenomatous polyposis (FAP), but total colectomy (TC) with rectal sparing can be performed in selected cases. The objective of this study is to determine and compare the incidence of methacronous cancer in the remanescent rectum in patients submitted to TPC or TC. Methods: We performed a retrospective analysis of 55 patients operated beteween 1992 and 2011. Patients were identified from 34 FAP families, registered at the AC Camargo Hereditary Colorectal Cancer Registry. Patients with attenuated FAP were excluded. The main endpoint was the occurence of cancer at the remanescent rectum. Results: Thirty seven patients were submitted to TPC and 18 to TC with ileo-rectal anastomosis. Among patients submitted to TPC, just one (2.7%) had methacronous adenocarcinoma just above the dentate line. Among patients submitted to TC with rectal sparing, 4 (22.2%) have another cancer at the remanescente rectum. This difference was statistically significant (0.035). The stage was initial in all cases, and all patients were submitted to salvage surgery. No deaths related to rectal cancer had occured. Conclusions: Surgical treatment of classical FAP still remains proctocolectomy with ileal pouch, whenever possible. Considering that methacronous cancer uses to be detected in initial stages, rectal sparing can be considered in very selected cases of classical FAP.

Laparoscopic salvage surgery for recurrent and metachronous colorectal cancer: 15 years’ experience in a single center

2011 ◽  
Vol 25 (11) ◽  
pp. 3551-3558 ◽  
Author(s):  
Soo Yeun Park ◽  
Gyu-Seog Choi ◽  
Soo Han Jun ◽  
Jun-Seok Park ◽  
Hye Jin Kim
Keyword(s):  
Colorectal Cancer ◽  
Salvage Surgery ◽  
Single Center ◽  
Metachronous Colorectal Cancer

Risk of recurrence after endoscopic resection of early colorectal cancer with positive margins

Endoscopy ◽  
2017 ◽  
Vol 50 (03) ◽  
pp. 241-247 ◽  
Author(s):  
Je-Wook Shin ◽  
Kyung Han ◽  
Jong Hyun ◽  
Sang Lee ◽  
Bun Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Resection Margin ◽  
Salvage Surgery ◽  
Positive Margin ◽  
Residual Tumor ◽  
Early Colorectal Cancer ◽  
Clinicopathological Factors ◽  
Positive Resection Margin ◽  
Additional Surgery

Abstract Background and study aim Additional surgery is recommended if an endoscopically resected T1 colorectal cancer (CRC) specimen shows a positive resection margin. We aimed to investigate the significance of a positive resection margin in endoscopically resected T1 CRC. Patients and methods We enrolled 265 patients with T1 CRC who underwent endoscopic resection between January 2001 and December 2016. The inclusion criteria were: 1) complete resection by endoscopy, and 2) pathology of a positive margin. Among the 265 patients, 213 underwent additional surgery and 52 did not. In the additional surgery group, various clinicopathological factors were evaluated with respect to the presence or absence of residual tumor. The follow-up results were assessed in the group that did not undergo additional surgery. Results In the 213 patients who underwent additional surgery, residual tumor was detected in 13 patients (6.1 %), and none of the clinicopathological factors was significantly associated with the presence of residual tumor. Among the 52 patients who did not undergo additional surgery, recurrence was detected in 4 (7.7 %), and all 4 underwent salvage surgery. Among these four patients, three had no risk factors for lymph node metastasis and recurrence was at the previous resection site; pathology was high grade dysplasia, rpT3N0M0, and rpT1N0M0, respectively. Conclusions A positive resection margin in endoscopically resected T1 CRC is related to a relatively low incidence of residual tumor (6.1 %). Although current guidelines recommend additional surgery for such cases, surveillance and timely salvage surgery could be another option in selected cases.

Intensive radiographic and CEA screening and salvage resection in patients with stage II and III colorectal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 405-405 ◽  
Author(s):  
Ahmad Ali Fora ◽  
Annie M Patta ◽  
Kristopher Attwood ◽  
Gregory E. Wilding ◽  
Marwan Fakih
Keyword(s):  
Colorectal Cancer ◽  
Recurrent Disease ◽  
Salvage Surgery ◽  
Stage Ii ◽  
High Rate ◽  
Surveillance Strategy ◽  
Salvage Resection ◽  
Significant Difference ◽  
Intensive Surveillance

405 Background: The objective of this study was to determine the rate of salvage resection in patients with stage II and III colorectal cancer following intensive surveillance. Methods: Patients with stage II and III colorectal cancer with a minimum follow-up of 3 years were included. CEA was obtained every 3 months for 2 years and then every 6 months for years 3 to 5. CT of the chest, abdomen and pelvis was performed every 6 months for 2 years and then yearly for years 3 to 5. Colonoscopy was performed at year 1 and then every 3 years. Results: 177 patients were followed for a median of 59.5 months. 51% were male, and 65 % had colon cancer. Compliance with screening was excellent with 92 % of patients undergoing all scheduled studies within 2 months of the planned date. At the time of this report, the median follow-up of the overall population was 5 years. 44 patients were diagnosed with recurrent disease. 91% of the recurrences were in the first 3 years of follow-up. CT and CEA were the first signs of recurrence in 68% and 14% of patients, respectively. Among the 30 patients diagnosed radiographically, 20 had a normal CEA. 25 patients (57%) with recurrent disease underwent curative intent resection, 12 of whom are still cancer free, with a median follow-up of 6.7 years from salvage surgery. The DFS and OS in the operated recurrent population from the time of salvage resection was 18.8 months (95% CI: 15.5 – 29.4) and not-reached (95% CI: 37.4, NR), respectively. The corresponding OS (from the time of recurrence) of the recurrent population without resection was 20.7 months (95% CI: 21.9, 63.4). The difference in OS between the two groups was highly significant (p = 0.0003). Among the patients undergoing resection, a significant difference was detected in the DFS of resected lung or liver metastases vs. extra-hepatic/pulmonary disease (p = 0.03) and a trend towards improved survival was noted (p = 0.07). Conclusions: Our intensive surveillance strategy resulted in the highest reported salvage rate in stage II and III colorectal cancer and led to a high rate of sustained remissions following salvage surgery. Intensive, 6-monthly, radiographic surveillance and its duration should be investigated further in randomized studies.

scholarly journals Endoscopic Therapy for Early Colorectal Cancer.

1993 ◽  
Vol 46 (8) ◽  
pp. 1007-1014
Author(s):  
S. Kudo ◽  
T. Nakajima ◽  
H. Kusaka ◽  
G. Iinuma ◽  
S. Hirota ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Therapy ◽  
Early Colorectal Cancer

scholarly journals Optimizing quality and efficacy of colorectal cancer diagnosis and endoscopic therapy

2020 ◽  
Author(s):  
van de Wetering Alouisa J.P.
Keyword(s):  
Colorectal Cancer ◽  
Cancer Diagnosis ◽  
Endoscopic Therapy

An introduction to colonic polypectomy

2019 ◽  
Vol 17 (Sup8) ◽  
pp. S22-S27
Author(s):  
Jonathan Fawkes
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Endoscopic Therapy ◽  
Colorectal Polyp ◽  
Bowel Cancer ◽  
Endoscopic Polypectomy ◽  
Common Cancer ◽  
Cancer Screening Programme ◽  
Bowel Cancer Screening ◽  
The Uk

Background: Colorectal cancer is the fourth most common cancer in the UK. The vast majority of colorectal cancers develop from polyps. Polypectomy is an endoscopic therapy that interrupts the sequence by which a polyp develops into cancer. Methods: A review was conducted of the published literature and clinical guidelines relevant to colonic polypectomy, with an aim to introduce basic concepts of colorectal polyp assessment and management and to describe potential complications of polypectomy. Findings: Through optical lesion assessment, it is possible to identify polyps with malignant potential. A number of techniques can be used to attempt removal, the goal of which is complete histological eradication in the safest way possible. Conclusion: Endoscopic polypectomy is a relatively safe intervention that is protective against colorectal cancer. Increasingly, nurses in the UK are being trained to perform polypectomy, particularly within the Bowel Scope service, which is part of the Bowel Cancer Screening Programme aimed at early diagnosis and removal of pre-cancerous, distal colorectal lesions.

Deletion mapping on chromosome 6 in colorectal cancer associated with ulcerative colitis

2001 ◽  
Vol 120 (5) ◽  
pp. A121-A122
Author(s):  
T EZAKI ◽  
M WATANABE ◽  
S FUNAKOSHI ◽  
M NAGANUMA ◽  
T AZUMA ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Deletion Mapping ◽  
Chromosome 6
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