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Published on: February 10, 2017
Is endoscopic submucosal dissection safe in the management of early-stage colorectal cancers?
Metincan Erkaya1, Attila Ulkucu1, Kamil Erozkan1
1Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
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.
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