Endoscopic treatment outcomes of laterally spreading tumors with a skirt (with video)

Shozo Osera, Hiroaki Ikematsu, Satoshi Fujii, Keisuke Hori, Yasuhiro Oono, Tomonori Yano, Kazuhiro Kaneko

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background and Aims A “skirt” is a slightly elevated flat lesion with wide pits occasionally observed at the margin of laterally spreading tumors (LSTs). However, the endoscopic treatment outcomes of LSTs with skirts have not been clarified. The aim of this study was to evaluate the endoscopic treatment outcomes of LSTs with skirts. Methods Between February 2006 and March 2014, 996 LSTs were retrospectively examined to assess the clinicopathologic characteristics, procedure time, en bloc resection rate, R0 resection rate, adverse events, and local recurrence rate of endoscopic submucosal dissection (ESD) and of endoscopic resection. Results Endoscopic treatment was performed in 35 cases of LSTs with skirts (ratio of ESD to endoscopic piecemeal mucosal resection [EPMR], 32:3) and 961 cases of LSTs without skirts (ratio of ESD to EMR to EPMR to polypectomy, 381:275:114:191). LSTs with a skirt were associated with a significantly higher recurrence rate (P <.01). In both ESD and EPMR, LSTs with a skirt were associated with a higher recurrence rate when compared with LSTs without a skirt (odds ratio, 12.7; P =.032, and odds ratio, 12.3; P =.061, respectively). Multivariate analysis demonstrated that the presence of the skirt and piecemeal resection were significant predictors of local recurrence. Conclusions LSTs with skirts had a significantly higher local recurrence rate after endoscopic treatment compared with LSTs without skirts, especially after EPMR. Therefore, ESD should be recommended as an endoscopic treatment for LSTs with skirts to minimize local recurrence.

Original languageEnglish
Pages (from-to)533-541
Number of pages9
JournalGastrointestinal Endoscopy
Volume86
Issue number3
DOIs
Publication statusPublished - Sep 2017
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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