Clinicopathological Features of Laterally Spreading Tumors Treated With Endoscopic Mucosal Resection

Aims Laterally spreading tumor (LST) is defined as superficial lesion at least 10 mm in diameter with lateral rather than vertical growth. They are usually underdiagnosed since they are flat making them unapparent and therefore these lesions harbor high risk for developing cancer. The study was aimed to describe the clinical and histopathological characteristics of laterally spreading tumor in our population. We also sought to measure residual lesion rates and efficacy and safety outcomes of endoscopic mucosal resection (EMR). In addition, the prevalence of synchronous colorectal lesions found in our study group was investigated.

Methods The study was designed as a retrospective analysis of a prospectively collected database of colonic LSTs endoscopically resected by an expert in our Clinic from October 2015-September 2020.

Results A total of 53 eligible patients were included for further analysis. The mean age of the enrolled was 67±10.55 years, 32 were man. A total of 53 LSTs were observed during endoscopy with a median size of 36.34 mm (range 10-70 mm), and 66 % were granular type (“G” type). The most common histological finding was tubulovillous adenoma with low-grade dysplasia and adenocarcinoma was observed in 5.66 % lesions. LSTs were most common in the rectum. Overall, 35 % (19/53) of patients showed at least one synchronous lesion which were mostly observed in the sigmoid colon with an average size of 12 mm (range 5-15 mm) and tubular adenomas were the most frequent. Most bleeding was observed during the procedure or within the first 48 h. No perforation was observed. R0 resection rate was accomplished in 18 % of cases.

Conclusions Laterally spreading tumors were most common in the rectum, and more often associated with invasive disease. EMR is safe but does not provide sufficient R0 resection rate.

Citation: Jankovic K, Jovanovic I. eP229 CLINICOPATHOLOGICAL FEATURES OF LATERALLY SPREADING TUMORS TREATED WITH ENDOSCOPIC MUCOSAL RESECTION. Endoscopy 2021; 53: S173.

Publication History

Article published online:
19 March 2021