Hepato-gastroenterology · 2014
Clinical outcomes of colonic mucosal cancers with histologically positive or uncertain resection margin after endoscopic resection.
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Ko Ock Bae, Byeon Jeong-Sik, Kim Mi Jung, Lim Hyun, Kim Min Jung, Yang Dong-Hoon, Yoon Soon Man, Kim Kyung-Jo, Ye Byong Duk, Myung Seung-Jae, Yang Suk-Kyun, Kim Jin-Ho
Аннотация
BACKGROUND/AIMS: Although incomplete endoscopic resection of colonic neoplasms can lead to the development of interval invasive cancer, few studies have assessed clinical outcomes after histologically incomplete resection of colonic mucosal cancer. We aimed to evaluate the clinical outcomes of patients with histologically positive or uncertain resection margins after endoscopically complete resection of colonic mucosal cancer.
METHODOLOGY: We analyzed the clinical course of 38 patients (median 62 years, male:female = 27:11) who underwent endoscopically complete resection of colonic mucosal cancer, but who showed histologically positive or uncertain resection margins.
RESULTS: The median size of the 38 colonic mucosal cancers was 14 mm (range, 5-50 mm). Of these, 20 were resected by a piecemeal resection, and had uncertain histological resection margins. The remaining 18 patients underwent en-bloc resection; of these, 16 had uncertain resection margins and 2 had positive margins. Patients underwent a median of 2.3 follow-up endoscopies (range, 1-7) during a median follow-up time of 18.3 months (range, 3-75 months). No local or distant recurrence was detected.
CONCLUSIONS: Cautious followup without immediate additional treatment can be considered for patients who undergo endoscopically complete resection of colonic mucosal cancers, even when histological examination shows uncertain or positive resection margins.
METHODOLOGY: We analyzed the clinical course of 38 patients (median 62 years, male:female = 27:11) who underwent endoscopically complete resection of colonic mucosal cancer, but who showed histologically positive or uncertain resection margins.
RESULTS: The median size of the 38 colonic mucosal cancers was 14 mm (range, 5-50 mm). Of these, 20 were resected by a piecemeal resection, and had uncertain histological resection margins. The remaining 18 patients underwent en-bloc resection; of these, 16 had uncertain resection margins and 2 had positive margins. Patients underwent a median of 2.3 follow-up endoscopies (range, 1-7) during a median follow-up time of 18.3 months (range, 3-75 months). No local or distant recurrence was detected.
CONCLUSIONS: Cautious followup without immediate additional treatment can be considered for patients who undergo endoscopically complete resection of colonic mucosal cancers, even when histological examination shows uncertain or positive resection margins.