EMR versus surgery for colon adenomas and early-stage cancers: a comparative effectiveness study.

BACKGROUND AND AIMS: EMR is the standard of care for eligible lesions. Its performance among a large, U.S.-based population is uncertain. The aim of this study was to compare medical and health care utilization outcomes between colon EMR and surgery in a community-based practice.

METHODS

This was a retrospective study of patients who underwent colon EMR versus surgery from 2008 to 2017. The primary outcome was all-cause mortality; secondary outcomes were recurrence rates and health care utilization.

RESULTS

The EMR group had 568 patients; the surgical group included 2054 patients. Patients were followed up for a mean of 4.5 years. Fewer EMR patients died versus surgical patients (hazard ratio, .31; 95% CI, .19-.495; P < .0001). All examined health care utilizations were lower in the EMR cohort (all, P < .0001).

CONCLUSIONS

Among patients with eligible colonic lesions, all-cause mortality and health care utilization was significantly lower in those treated with EMR in a community-based practice.