Year 2020 / Volume 112 / Number 3
Original
Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort

172-177

DOI: 10.17235/reed.2020.6268/2019

Julia Arribas Anta, Ángel Cañete Ruiz, Teresa Álvarez-Nava Torrego, Carlos Piedracoba-Cadahía, David Rafael de la Cruz Esteban, Marta Rodríguez Carrasco, Esteban Romero Romero, Andrés José del Pozo-García, Sarbelio Rodríguez Muñoz, José Díaz-Tasende, José Carlos Marín-Gabriel,

Abstract
Introduction: ESD in the colon is an increasingly important technique in Western countries. There are few studies that include long term follow-up. Aim: to analyze the long term recurrence free survival rate after ESD and to compare recurrence rates according to different variables. Methods: this was a prospective observational study of patients with a planned ESD from September 2008 to December 2015. When it was not possible to achieve an ESD, hybrid ESD was performed, either en bloc or piecemeal. Kaplan-Meier survival curves were used to assess the five year local recurrence free survival rate and the recurrence rate. The results were compared according to different factors. Results: of the 89 patients scheduled for ESD who were initially enrolled in the study, 69 were finally included for follow-up. ESD was performed in 31 (45%) patients, KAR in eleven (16%) and pKAR in 27 (39%). The median follow-up was 27 months (range 6-60). The five year disease free survival rate was 81%. The average number of endoscopies needed to eliminate recurrence was two (range 2-7) and no patient required surgery for this reason. The recurrence rate was significantly higher in piecemeal resections vs en bloc resections (27% vs 15%, p = 0.036) and R1 resections vs R0 resections (26% vs 0%, p = 0.034). The presence of affected or unknown lateral margins in en bloc resections without other poor prognosis factors had higher recurrence rates but the difference was not statistically significant (28% vs 0%, p = 0.09). Conclusions: in our study, the five year disease free survival rate was 81% and no patient required surgery during follow-up. Piecemeal and R1 resections had significantly higher recurrence rates, as well as LM involvement, although this was not statistically significant.
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Arribas Anta J, Cañete Ruiz Á, Álvarez-Nava Torrego T, Piedracoba-Cadahía C, Rafael de la Cruz Esteban D, Rodríguez Carrasco M, et all. Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort. 6268/2019


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Publication history

Received: 07/03/2019

Accepted: 02/01/2020

Online First: 14/02/2020

Published: 05/03/2020

Article revision time: 297 days

Article Online First time: 344 days

Article editing time: 364 days


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