Endoscopy 2019; 51(04): S90
DOI: 10.1055/s-0039-1681436
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 08:30 – 10:30: Colonic polyps: characterization Club D
Georg Thieme Verlag KG Stuttgart · New York

PROSPECTIVE EVALUATION OF CONECCT CLASSIFICATION WITH 237 COLORECTAL ESD

J Albouys
1   CHU Dupuytren, Limoges, France
,
M Pioche
2   Edouard Herriot University Hospital, Lyon, France
,
M Fabritius
2   Edouard Herriot University Hospital, Lyon, France
,
R Legros
1   CHU Dupuytren, Limoges, France
,
J Rivory
2   Edouard Herriot University Hospital, Lyon, France
,
D Sautereauau
1   CHU Dupuytren, Limoges, France
,
T Ponchon
2   Edouard Herriot University Hospital, Lyon, France
,
J Jacques
1   CHU Dupuytren, Limoges, France
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Several classifications has been developed to predict the risk of submucosal invasion in case of superficial colorectal lesion. We developed the CONECCT classification that merged all existing classification (Paris, SANO, KUDO, WASP, LST, NICE) in one table to simplify endoscopic characterization.

Methods:

Bicenter prospective study of all characterization data recorded before ESD for large superficial colorectal lesions. Sensibility (Se) Specificity (Spe) Positive predictive value (PPV) Negative predictive value (NPV) of presence of macronodule on a LST-G, SANO IIIA, Paris 0-IIC and CONECCT IIC were calculated.

Results:

400 colorectal ESD were performed between 01/2017 and 09/2018 at 2 experts centers. 237 lesions with a mean size of 60 mm that had all characterization data (Paris, SANO, KUDO, WASP, LST, NICE, CONECCT) were included. 167 (70%) of lesions were LST-G, 45 (19%) LST-NG and 26 (11%) Polyp. 165 (69,6%) were CONECCT IIc, 87 SANO IIIA (37%) and 35 (14,8%).

Histological analysis: LGD: 87 (37%); HGD: 72 (30,4%); IM carcinoma: 56 (23,6%); Sm < 1000: 14 (6%), sm > 1000: 7 (3%) T2: 1 (0,5%).

LST with macro nodule

  • Intra mucosal cancer: Sen = 84.4%/Spe = 55.9%/VPP = 50.5%/VPN = 87.1%

  • Submucosal cancer: Sen = 100%/Spe = 45.7%/VPP = 14.4%/VPN = 100%

Paris IIC

  • Intra mucosal cancer: Sen = 20.5%/Spe = 88%/VPP = 45.7%/VPN = 69.3%

  • Submucosal cancer: Sen = 36.3%/Spe = 87.4%/VPP = 22.8%/VPN = 93%

Sano IIIA

  • Intra mucosal cancer (51.7%): Sen = 58.4%/Spe = 78.5%/VPP = 51.7%/VPN = 78.5%

  • Submucosal cancer (19.5%): Sen = 80.9%/Spe = 67.4%/VPP = 19.5%/VPN = 97.3%

CONECCT IIC

  • Intra mucosal cancer: Sen = 93.5%/Spe = 42.1%/VPP = 44.2%/VPN = 93%

  • Submucosal cancer: Sen = 100%/Spe = 33.4%/VPP = 13.3%/VPN = 100%.

Conclusions:

The CONECCT classification allows to predict with a 100% sensibility the risk of submucosal invasion, requiring an En-bloc resection.