内镜下粘膜剥离治疗早期结直肠癌安全吗？

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-12-20 DOI:10.1016/j.amjsurg.2024.116159

Metincan Erkaya , Attila Ulkucu , Kamil Erozkan , Brogan Catalano , Daniela Allende , Scott Steele , Joshua Sommovilla , Emre Gorgun

{"title":"内镜下粘膜剥离治疗早期结直肠癌安全吗？","authors":"Metincan Erkaya , Attila Ulkucu , Kamil Erozkan , Brogan Catalano , Daniela Allende , Scott Steele , Joshua Sommovilla , Emre Gorgun","doi":"10.1016/j.amjsurg.2024.116159","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic submucosal dissection (ESD) is increasingly being adopted for the treatment of early-stage colorectal cancer (CRC) lesions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with early-stage CRC treated between 2015 and 2023, using ESD and colectomy databases, categorizing them into three groups: ESD only (n = 24), oncological colorectal resection (OCR) only (n = 90), and OCR after ESD (n = 59). We compared pathological and oncological outcomes among these groups.</div></div><div><h3>Results</h3><div>The OCR after ESD group demonstrated higher non-granular lesions, and deeper submucosal invasion compared to ESD only group. The primary OCR group showed higher 2-year overall survival compared to ESD-only group (98.9 % vs 85.6 %, p = 0.01), with no colorectal cancer-related mortality in any of the groups. Notably, 2-year disease-free survival rates were comparable across all groups (93.8 % ESD only, 88.0 % primary OCR only, and 97.8 % for OCR after ESD, p = 0.27).</div></div><div><h3>Conclusion</h3><div>The current study highlights feasibility the promising potential and oncologic safety of ESD in carefully selected patients with early malignant lesions.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116159"},"PeriodicalIF":2.7000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Is endoscopic submucosal dissection safe in the management of early-stage colorectal cancers?\",\"authors\":\"Metincan Erkaya , Attila Ulkucu , Kamil Erozkan , Brogan Catalano , Daniela Allende , Scott Steele , Joshua Sommovilla , Emre Gorgun\",\"doi\":\"10.1016/j.amjsurg.2024.116159\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Endoscopic submucosal dissection (ESD) is increasingly being adopted for the treatment of early-stage colorectal cancer (CRC) lesions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with early-stage CRC treated between 2015 and 2023, using ESD and colectomy databases, categorizing them into three groups: ESD only (n = 24), oncological colorectal resection (OCR) only (n = 90), and OCR after ESD (n = 59). We compared pathological and oncological outcomes among these groups.</div></div><div><h3>Results</h3><div>The OCR after ESD group demonstrated higher non-granular lesions, and deeper submucosal invasion compared to ESD only group. The primary OCR group showed higher 2-year overall survival compared to ESD-only group (98.9 % vs 85.6 %, p = 0.01), with no colorectal cancer-related mortality in any of the groups. Notably, 2-year disease-free survival rates were comparable across all groups (93.8 % ESD only, 88.0 % primary OCR only, and 97.8 % for OCR after ESD, p = 0.27).</div></div><div><h3>Conclusion</h3><div>The current study highlights feasibility the promising potential and oncologic safety of ESD in carefully selected patients with early malignant lesions.</div></div>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"241 \",\"pages\":\"Article 116159\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0002961024007116\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024007116","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

摘要

背景：内镜下粘膜下剥离术（ESD）越来越多地被用于早期结直肠癌（CRC）病变的治疗。方法：我们回顾性分析2015年至2023年期间接受ESD和结肠切除术治疗的早期结直肠癌患者，将其分为三组：仅ESD (n = 24)，仅肿瘤结肠切除术（n = 90）和ESD后的OCR （n = 59）。我们比较了这些组的病理和肿瘤结果。结果：与单纯ESD组相比，ESD组术后的OCR显示出更多的非颗粒状病变，粘膜下浸润更深。原发性OCR组的2年总生存率高于单纯esd组（98.9% vs 85.6%, p = 0.01），两组均无结直肠癌相关死亡率。值得注意的是，所有组的2年无病生存率具有可比性（仅ESD为93.8%，仅原发性OCR为88.0%，ESD后OCR为97.8%,p = 0.27）。结论：本研究强调了ESD在精心挑选的早期恶性病变患者中的可行性、前景和肿瘤安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Is endoscopic submucosal dissection safe in the management of early-stage colorectal cancers?

Background

Endoscopic submucosal dissection (ESD) is increasingly being adopted for the treatment of early-stage colorectal cancer (CRC) lesions.

Methods

We retrospectively analyzed patients with early-stage CRC treated between 2015 and 2023, using ESD and colectomy databases, categorizing them into three groups: ESD only (n = 24), oncological colorectal resection (OCR) only (n = 90), and OCR after ESD (n = 59). We compared pathological and oncological outcomes among these groups.

Results

The OCR after ESD group demonstrated higher non-granular lesions, and deeper submucosal invasion compared to ESD only group. The primary OCR group showed higher 2-year overall survival compared to ESD-only group (98.9 % vs 85.6 %, p = 0.01), with no colorectal cancer-related mortality in any of the groups. Notably, 2-year disease-free survival rates were comparable across all groups (93.8 % ESD only, 88.0 % primary OCR only, and 97.8 % for OCR after ESD, p = 0.27).

Conclusion

The current study highlights feasibility the promising potential and oncologic safety of ESD in carefully selected patients with early malignant lesions.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.