Endoscopy 2021; 53(S 01): S59
DOI: 10.1055/s-0041-1724401
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Relevance of R0 Resection to Reduce Local Recurrence After Endoscopic Submucosal Dissection for Colorectal Neoplasms: Results from a Spanish Cohort of 188 Cases

D de Frutos
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
J Santiago
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
I Omella
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
B Agudo
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
B Tormo
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
M Hernández
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
M López
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
B Conde
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
A Garrido
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
L De la Corte
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
,
A Herreros-de-Tejada
1   Puerta de Hierro University Hospital, Gastroenterology and Hepatology, Majadahonda, Spain
2   MD Anderson Cancer Center, Gastroenterology and Hepatology, Madrid, Spain
3   La Luz Hospital, Gastroenterology and Hepatology, Madrid, Spain
› Author Affiliations
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    Aims Assess recurrence rate and disease-free survival time after colorectal endoscopic submucosal dissection (CR-ESD) of colorectal neoplasms (CN) in a Spanish cohort and compare both in relation to complete histologic R0 resection (free deep and lateral margins).

    Methods Consecutive assessment of all CR-ESD for CN with at least one follow-up endoscopy performed by the same group of Spanish endoscopists in 3 tertiary centers from January 2013 to May 2020. Patients undergoing surgical resection due to major adverse event or elective procedure after non-curative pathology result were excluded (unable to verify local recurrence).

    The disease-free survival time and the hazard ratio for recurrence risk were determinate using Kaplan-Meier and Nelson-Aalen method. The log-rank test was used to compare survival functions by groups. Statistical analyses were carried out using Stata v15.1.

    Results A total of 188 CR-ESD were included ([table 1]). The mean follow-up period was 18.7 months (Range 3-83). Only 3 cases of local recurrence were identified. The 6-months recurrence rate was 0.5 % (CI95: 0.08-3.8 %), with statistical significative differences between R0 resection and R1 groups (log-rank test; 0 % vs 3.6 %, p=0.01).

    Age, years. Mean (SD)

    67.2 (9.4)

    R0 %

    85.1 %

    Sex male %

    53.2 %

    LGD (Vienna 3)

    123 (65.4 %)

    Lesion maximum diameter, mm. Mean (SD)

    39.6 (17.9)

    HGD (Vienna 4)

    48 (25.5 %)

    Procedure time, min. Mean (SD)

    101.9 (61.7)

    SM invasive Ca. (Vienna 5)

    5 (2.7)

    En-bloc %

    94.2 %

    Time to first follow-up endoscopy, months. Md (P25-P75)

    12 (7.1-14.1)

    Conclusions CR-ESD can be an effective technique for large CN resection, with a very low recurrence rate.

    Achieving R0 resection (free deep and lateral margin at histology assessment) appears to be a determinant factor to avoid local recurrence. CR-ESD in European centers can accomplish similar outcomes (R0 and recurrence rate) to those described in large Japanese series.

    Citation: de Frutos D, Santiago J, Omella I et al. OP143 RELEVANCE OF R0 RESECTION TO REDUCE LOCAL RECURRENCE AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL NEOPLASMS: RESULTS FROM A SPANISH COHORT OF 188 CASES. Endoscopy 2021; 53: S59.


     

    Publication History

    Article published online:
    19 March 2021

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