Chinese expert consensus on additional surgery following endoscopic resection for early colorectal cancer (2025 edition).

Abstract

Early colorectal cancer is often treated through endoscopic procedures to remove tumors. However, when initial removal is incomplete or shows high-risk features, further major surgery is required to ensure no cancer remains. This consensus provides a standard for surgeons to decide when and how to perform this additional surgery. A multidisciplinary group of Chinese medical experts reviewed global research and clinical evidence published between 2010 and 2024. The medical experts formulated key clinical recommendations, which were then discussed and finalized through expert voting to ensure high agreement. The consensus identifies specific high-risk factors necessitating additional surgery. The consensus recommends that these follow-up surgeries should ideally take place approximately 4 weeks after the first procedure. Furthermore, the consensus provides detailed protocols for marking the tumor location and selecting the best surgical approach. These consensuses offer a practical framework to improve the safety and effectiveness of treating early colorectal cancer. By standardizing surgical decisions, the consensus aims to help patients achieve better long-term recovery and quality of life.