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Background and Aims <p>Endoscopic submucosal dissection (ESD) is preferred over endoscopic mucosal resection (EMR) for resection of colon cancer with suspected superficial invasion. Data on appropriate utilization of ESD such as rates of cancer and non-curative resection (NCR) are under-reported.</p> Methods <p>Retrospective multicenter study of 547 consecutive colonic lesions undergoing ESD was performed. Outcomes were rates of cancer, NCR, surgery and predictors of NCR.</p> Results <p>Of all lesions, histopathology demonstrated cancer in 12% (n = 66). Overall, NCR was seen in 59.1% (n = 39) patients and 24.6% (n = 135) lesions contained high-grade dysplasia. For NCR, patients underwent surgery in 7.6% (n = 3) and adverse events were observed in 8.8% (n = 48).</p> Conclusions <p>In our large multicenter Western cohort, the pathology was found to be benign in most of the colon ESDs and there was high NCR for resected lesions with cancer. The overall surgery rate, however, remained low. This study highlights the need to refine lesion selection criteria while continuing to optimize ESD technique to match the efficiency and safety of EMR.</p>

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Rates of Cancer, Non-curative Resection, Adverse Event and Surgery After Colonic Endoscopic Submucosal Dissection (ESD)—Results from a Large International Multicenter Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月16日

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  • Rahul Karna,
  • Jonathan Colón Sánchez,
  • Kevan Josloff,
  • Tammy Tran,
  • Kasenee Tiankanon,
  • Saowanee Ngamruengphong,
  • Elisabet Maristany Bosch,
  • Georgios Kalopitas,
  • Edward John Despott,
  • Alberto Murino,
  • Shaimaa Elkholy,
  • Mohamed El Sherbiny,
  • Karim Essam,
  • Hany Haggag,
  • Abeer Awad Abdallatef,
  • Kerolis Yousef,
  • Rossella Maresca,
  • Federico Barbaro,
  • Galen Leung,
  • Frances Dang,
  • Amirali Tavangar,
  • Jason Samarasena,
  • Ahmed Saeed,
  • Sherif Andrawes,
  • Yutaka Tomizawa,
  • Mohammad Bilal,
  • Kartik Sampath,
  • Yasi Xiao,
  • Faisal Kamal,
  • Thomas Kowalski,
  • Alexander Schlachterman,
  • Anand R. Kumar

摘要

Background and Aims

Endoscopic submucosal dissection (ESD) is preferred over endoscopic mucosal resection (EMR) for resection of colon cancer with suspected superficial invasion. Data on appropriate utilization of ESD such as rates of cancer and non-curative resection (NCR) are under-reported.

Methods

Retrospective multicenter study of 547 consecutive colonic lesions undergoing ESD was performed. Outcomes were rates of cancer, NCR, surgery and predictors of NCR.

Results

Of all lesions, histopathology demonstrated cancer in 12% (n = 66). Overall, NCR was seen in 59.1% (n = 39) patients and 24.6% (n = 135) lesions contained high-grade dysplasia. For NCR, patients underwent surgery in 7.6% (n = 3) and adverse events were observed in 8.8% (n = 48).

Conclusions

In our large multicenter Western cohort, the pathology was found to be benign in most of the colon ESDs and there was high NCR for resected lesions with cancer. The overall surgery rate, however, remained low. This study highlights the need to refine lesion selection criteria while continuing to optimize ESD technique to match the efficiency and safety of EMR.