Clinical outcome of endoscopically removed early colorectal cancer

Endoscopic resection is widely adopted for early colorectal cancer. Most studies examining the effectiveness of endoscopic treatment of early colorectal cancer are from Japan, and little is known about the success of this treatment in other areas of the world. The authors performed this study to investigate the effectiveness of endoscopic treatment of early colorectal cancer.

The medical records of patients with histologically proven early colorectal cancer and who were treated by endoscopic resection between January 1985 and December 2000 were reviewed retrospectively. Information regarding the demographic data of patients, clinicopathological characteristics of the tumors, and follow-up events were recorded and analyzed.

Altogether 91 patients, including 73 with mucosal cancers and 18 with submucosal invasive cancers, were enrolled. Nineteen patients (eight with mucosal cancers and 11 with submucosal invasive cancers) underwent subsequent surgical colectomy. Larger tumors, and those with sessile or flat depressed morphology, and deep submucosal invasion were more difficult to remove completely through endoscopic resection alone. Five patients had local recurrent tumors, occurring between 4 and 12 months after endoscopic resection, and were treated surgically. Furthermore, two patients died of unrelated diseases, one at 1 month and one at 3 years after treatment. All the other patients were well after an average follow-up interval of 40.9 months (range 18-189 months).

Endoscopic resection safely and effectively removed most early colorectal cancers. Careful histological examinations of resected specimens to determine the indications of subsequent surgical colectomy, and close post-treatment surveillance would improve the outcome and life quality for these patients.