Chang Woo Kim, MD1, Sun Jin Park, MD2, Kil Yeon Lee, MD2, Suk-Hwan Lee, MD1. 1Kyung Hee University Hospital at Gangdong, 2Kyung Hee University Medical Center
Introduction: The aim of this study was investigate the safety of Endoscopic mucosal resection (EMR) for early colorectal cancer comparing with outcomes of radical resection after EMR. EMR has been applied for early colorectal cancer with the strict indications. The radical resection after EMR is often required if the known risk factors including poor differentiation, lymphovascular invasion, resection margin involvement, and deep invasion depth.
Methods: Between June 2006 and June 2017, 8490 EMRs were performed for 5250 patients with colorectal polyps at Kyung Hee University Hospital at Gangdong. After the patients with benign polyps were excluded among them, medical records and pathologic reports were reviewed. Colonoscopic finding and pathologic variables were analyzed and compared.
Results: A total of 103 patients underwent EMR for early colorectal cancer. 40 patients had risk factors and were recommended for surgery after EMR, whereas 28 patients among them underwent surgery. 12 patients refused surgery due to old age, poor condition, and avoidance of stoma formation. In contrast, one patient without risk factors underwent surgery because he wanted.
The gross types of polyp and tumor size were not different between the two groups. However, rectal polyps than colon polyps were found frequently in the observation group than in the surgery group (25.7% vs. 10.3%, P=0.047). In addition, there were more favorable differentiation of the tumor and shallow depth of invasion in the observation group. In contrast, lymphovascular invasion and resection margin involvement were more found in the surgery group (34.5% vs. 1.4%, P<0.001 and 20.7% vs. 4.1%, P<0.001, respectively). During 48.4 months of follow up period, no recurrence was noted in the both groups.
Conclusion: EMR for early colorectal cancer appeared to be safe and feasible. Pathologic reports as well as colonoscopic findings are important to decide performing surgery or observation. Even some patients with risk factors could benefit from EMR alone, but close surveillance is mandatory to confirm long-term oncologic results.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87144
Program Number: P221
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster