Metachronous neoplasia and local recurrence after colorectal endoscopic submucosal dissection

Daisuke Takei, Keita Harada, Shiho Takashima, Toshihiro Inokuchi, Asuka Nakarai, Yuusaku Sugihara, Masanobu Takahara, Sakiko Hiraoka, Hiroyuki Okada

Research output: Contribution to journalArticle

Abstract

Several reports discussed colonoscopic surveillance after polypectomy and endoscopic mucosal resection (EMR) for colorectal polyps, but only a few reports focused on prognostic analyses, and none involved metachronous neoplasia after colorectal endoscopic submucosal dissection (ESD). We conducted the present study to assess the risk of adenoma recurrence requiring endoscopic treatment, and to establish appropriate post-ESD colonoscopic surveillance. We enrolled 116 patients who had undergone colorectal ESD at Okayama University Hospital between February 2008 and July 2014 and had been followed-up >12 months. We retrospectively analyzed clinicopathological features of 101 lesions from 101 patients. Metachronous adenomas were detected in 21 cases (20.8%). We divided the patients into 2 groups according to the occurrence of metachronous adenomas. Our comparison of clinicopathological characteristics between these groups showed that in the metachronous adenomas group the number of synchronous adenomas at index colonoscopy was high and the rate of laterally spreading tumor-nongranular (LST-NG) was higher. A multivariate analysis indicated that the number of synchronous adenomas was significantly associated with metachronous adenomas (HR: 2.54, 95%CI: 1.04-6.52, p<0.05). The colonoscopic surveillance planning after colorectal ESD should be more meticulous for patients with more synchronous adenomas.

Original languageEnglish
Pages (from-to)475-483
Number of pages9
JournalActa Medica Okayama
Volume71
Issue number6
Publication statusPublished - Jan 1 2017

    Fingerprint

Keywords

  • endoscopic submucosal dissection
  • Laterally spreading tumor
  • Local recurrence
  • Metachronous recurrence
  • Post-ESD colonoscopic surveillance

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this