Portal de Periódicos da CAPES

Sa1578 Short and Long Term Follow Up of Endoscopic Mucosal Resection of High Grade Dysplasia and Intramucosal Colorectal Cancer

2011; Elsevier BV; Volume: 73; Issue: 4 Linguagem: Inglês

10.1016/j.gie.2011.03.313

1097-6779

Pablo C. Rodríguez, Amado Escobar, Carolina Bolino, Santiago De Elizalde, Alejandra Avagnina, Boris Elsner, Enzo Domenichini, E. Luis, Cecilio L. Cerisoli,

Genetic factors in colorectal cancer

Risk of lymphatic or blood dissemination of colorectal cancer (CRC) limited to the mucosa and superficial submucosa is low. In these cases, Endoscopic Mucosal Resection (EMR) can be considered a treatment alternative. The efficacy and safety of the procedure has been demonstrated, but only few studies report the recurrence rate after the procedures. To evaluate the short and long-term outcomes of EMR of High Grade Dysplasia (HGD) and Intramucosal (IM) Colorectal Cancer. Adults with High Grade Dysplasia (HGD), Intramucosal (IM) or superficial submucosal colorectal cancer who underwent complete EMR using a submucosal saline injection technique were eligible for surveillance. Patients with invasive carcinoma, incomplete EMR, or a nonlifting sign were referred to surgery. The study was carried out in an outpatient GI clinic in Buenos Aires city between 2005 and 2009. The first follow-up endoscopic examination was performed at 3-6 mo after initial endoscopic resection, the second at 12 mo post- EMR, and subsequent surveillance colonoscopic examinations were individualized. The study design was descriptive, retrospective, observational, and cross sectional. Recurrence was defined as the presence of any amount of adenomatous or carcinomatous tissue on follow-up, confirmed by histology at the site of prior resection. VCCSTAT 2.0. 60/394 EMR were diagnosed with HGD, intramucosal or superficial submucosal CRC. Twelve patients were referred to surgery, 18 were lost to follow up, and a total of 30 patients were followed up. Average age was 63 years, 56% were male, and all were white. Sixty-three percent of lesions were polypoid; mean size was 35mm and the rectum was the most frequent location (27%). Mean follow up period was three years. Recurrence was identified in 3 patients (10%, 95% CI 2.1 - 26). The characteristics of patients with recurrent lesions are shown in Table 1.Table 1Characteristics of patients with recurrent lesions.AgeSexMorphologyLocationSizePrimary HistologyTime to recurrence (mo)Recurrent HistologyFollow up (mo)63MPolypoidRectum60mmVillous Adenoma Vienna 43 moTubulovillous adenoma42 mo58MPolypoidAscending20mmTubulovillous adenoma Vienna 46 moTubular adenoma18 mo51FNon PolypoidSigmoid25mmTubulovillous adenoma Vienna 412 moTubular adenoma12 mo Open table in a new tab EMR is an effective technique. Recurrence of lesions occurred in the short term, within 12 months post-EMR. This finding supports the concept that close follow-up endoscopic examinations are necessary for early detection of recurrence.