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EMR versus surgery for colon adenomas and early-stage cancers: a comparative effectiveness study
Karl Kwok1, Chun Chao2, Rui Yan2
1Department of Gastroenterology, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, California, USA.
Background And Aims:
EMR is the standard of care for eligible lesions. Its performance among a large, U.S.-based population is uncertain. The aim of this study was to compare medical and health care utilization outcomes between colon EMR and surgery in a community-based practice.
Methods:
This was a retrospective study of patients who underwent colon EMR versus surgery from 2008 to 2017. The primary outcome was all-cause mortality; secondary outcomes were recurrence rates and health care utilization.
Results:
The EMR group had 568 patients; the surgical group included 2054 patients. Patients were followed up for a mean of 4.5 years. Fewer EMR patients died versus surgical patients (hazard ratio, .31; 95% CI, .19-.495; P < .0001). All examined health care utilizations were lower in the EMR cohort (all, P < .0001).
Conclusions:
Among patients with eligible colonic lesions, all-cause mortality and health care utilization was significantly lower in those treated with EMR in a community-based practice.
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