Tumor size discrepancy between endoscopic and pathological evaluations in colorectal endoscopic submucosal dissection

Area of Science:

• Gastroenterology
• Surgical Oncology
• Medical Imaging

Background:

• Accurate preoperative tumor size assessment is crucial for colorectal endoscopic submucosal dissection (ESD) success.
• Discrepancies between endoscopic and pathological tumor size evaluations can complicate procedures.

Purpose of the Study:

• To investigate the discrepancy in tumor size between endoscopic and pathological evaluations in colorectal ESD.
• To identify factors influencing inaccurate preoperative tumor size estimations.

Main Methods:

• Retrospective analysis of 377 colorectal lesions treated with ESD.
• Comparison of endoscopic and pathological tumor sizes, categorizing discrepancies into correct, undersized, and oversized groups.
• Multivariate analysis to identify factors influencing size estimation accuracy.

Main Results:

• A mean size discrepancy of 21% was observed, with 91 lesions incorrectly estimated.
• Larger tumor size and less operator experience were associated with underestimation.
• Smaller tumor size was significantly associated with overestimation.

Conclusions:

• Colorectal tumors undergoing ESD are frequently underestimated when large and overestimated when small.
• Understanding these size discrepancies is vital for optimizing ESD procedural preparation and outcomes.