1. Low value of second-look endoscopy for detecting residual colorectal cancer after endoscopic removal
- Author
-
E. M. Witteman, Marc A.W.M. van Milligen de Wit, Rogier de Ridder, Marco J. Bruno, Wouter H. de Vos tot Nederveen Cappel, Pieter J.C. ter Borg, Evelien Dekker, Dirk Jan Bac, Monique E. van Leerdam, Stephan Schmittgens, Thjon J. Tang, Ludger S.M. Epping Stippel, Tanya M. Bisseling, Ramon-Michel Schreuder, Frank P. Vleggaar, Anke M. Zonneveld, Ruud W.M. Schrauwen, Ivonne Leeuwenburgh, Leon M G Moons, Yasser A. Alderlieste, Niels van Lelyveld, Muhammed Hadithi, Rob M. E. Slangen, Frank ter Borg, Renzo P. Veenstra, Rolf van Roermund, Zoe Post, Arjun D. Koch, P. Honkoop, Kim M. Gijsbers, Gastroenterology & Hepatology, Gastroenterology and Hepatology, AGEM - Re-generation and cancer of the digestive system, CCA - Imaging and biomarkers, APH - Quality of Care, Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), and RS: FHML non-thematic output
- Subjects
medicine.medical_specialty ,Neoplasm, Residual ,recurrence ,RESECTION ,Colorectal cancer ,Colonoscopy ,SDG 3 - Good Health and Well-being ,Biopsy ,Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14] ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,LYMPH-NODE METASTASIS ,Cancer ,medicine.disease ,Confidence interval ,Endoscopy ,Clinical trial ,RISK-FACTORS ,Radiology ,Colorectal Neoplasms ,business - Abstract
Contains fulltext : 225271.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: Endoscopic resection is often feasible for submucosal invasive colorectal cancers (T1 CRCs) and usually judged as complete. If histology casts doubt on the radicality of resection margins, adjuvant surgical resection is advised, although residual intramural cancer is found in only 5% to 15% of patients. We assessed the sensitivity of biopsy specimens from the resection area for residual intramural cancer as a potential tool to estimate the preoperative risk of residual intramural cancer in patients without risk factors for lymph node metastasis (LNM). METHODS: In this multicenter prospective cohort study, patients with complete endoscopic resection of T1 CRC, scheduled for adjuvant resection due to pathologically unclear resection margins, but absent risk factors for LNM, were asked to consent to second-look endoscopy with biopsies. The results were compared with the pathology results of the surgical resection specimen (criterion standard). RESULTS: One hundred three patients were included. In total, 85% of resected lesions were unexpectedly malignant, and 45% were removed using a piecemeal resection technique. Sixty-four adjuvant surgical resections and 39 local full-thickness resections were performed. Residual intramural cancer was found in 7 patients (6.8%). Two of these patients had cancer in second-look biopsy specimens, resulting in a sensitivity of 28% (95% confidence interval
- Published
- 2020
- Full Text
- View/download PDF