Turkish Journal of Gastroenterology
Gastrointestinal Endoscopy - Original Article

Risk factors associated with clinical outcomes of endoscopic mucosal resection for colorectal laterally spreading tumors: A Honam Association for the Study of Intestinal Diseases (HASID) multicenter study

1.

Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

2.

Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea

3.

Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea

4.

Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea

5.

Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea

Turk J Gastroenterol 2019; 30: 350-356
DOI: 10.5152/tjg.2019.18393
Read: 870 Downloads: 108 Published: 25 July 2019

Abstract

Background/Aims: Colorectal laterally spreading tumors (LSTs) are large and superficial neoplasms. Most are adenomatous lesions. Endoscopic mucosal resection (EMR) is a standard technique of removing precursor colorectal lesions. The aim of the present study was to assess the factors associated with the clinical outcomes of EMR for LSTs.

 

Materials and Methods: A total of 275 patients with LSTs who underwent EMR were enrolled in the study. The clinical outcomes of the patients were analyzed by retrospectively reviewing their medical records.

 

Results: The en bloc resection and R0 resection rates were 86.9% and 80.4%, respectively. The bleeding and perforation rates were 7.6% and 0.4%, respectively. The frequency of high-grade dysplasia and adenocarcinoma histology was significantly higher, and the procedure time was significantly longer in LSTs >20 mm than in those ≤20 mm. The R0 resection rate was significantly higher in LSTs ≤20 mm than in those >20 mm. The frequency of piecemeal resection was significantly higher in LSTs with an adenomatous and cancerous pit pattern than in those with a non-neoplastic pit pattern. The frequency of piecemeal resection was significantly higher in LSTs with adenocarcinoma than in those with low-grade dysplasia. Multivariate analysis revealed that adenomatous pit pattern, high-grade dysplasia, or adenocarcinoma was a significant independent risk factor of LSTs for piecemeal resection after EMR.

 

Conclusion: EMR is useful for treating ≤20 mm LSTs with regard to curative resection and procedure time. LSTs with an adenomatous pit pattern, high-grade dysplasia, or adenocarcinoma are significant independent risk factors for piecemeal resection after EMR.

 

Cite this article as: Son DJ, Kweon SS, Kim SW, et al. Risk factors associated with clinical outcomes of endoscopic mucosal resection for colorectal laterally spreading tumors: A Honam Association for the Study of Intestinal Diseases (HASID) multicenter study. Turk J Gastroenterol 2019; 30(4): 350-6.

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