1.Follow-up Results of Endoscopic Mucosal Resection for Early Colorectal Cancer.
Hee Jung LEE ; Hyun Yong JEONG ; Nam Hwan PARK ; Sun Chang HONG ; Gwan Woo NAM ; Hee Seok MOON ; Eaum Seok LEE ; Seok Hyun KIM ; Jae Kyu SUNG ; Byung Seok LEE
The Korean Journal of Gastroenterology 2011;57(4):230-236
BACKGROUND/AIMS: Recently colonoscopy and screening programs have led to the detection and removal of increasing numbers of early colorectal cancer (ECC), which can reduce its related mortality. We analysed the clinical, endoscopic, and histologic findings, as well as the follow-up data, to evaluate the effectiveness and the long-term results of endoscopic mucosal resection (EMR) for ECC. METHODS: We analysed, retrospectively, 94 lesions in 92 patients who underwent EMR for ECC from January 2002 to June 2009. RESULTS: The overage age of patients was 60 years old. The mean follow-up period was 22.1 months (6-80). En bloc resection rate was 64.9%. Submucosal invasion was found in 30 cases (31.9%). De novo cancer rate was 26.6% which had higher submucosal invasion rate (60%, p=0.003). The complete resection rate was 87.2%, and there was no recurrence of cancer during follow-up (p=0.000). Twelve incomplete resection cases had received further surgical treatments. No procedure-related mortality was found and no recurrent malignancy was found except 1 case. CONCLUSIONS: This study shows that EMR is an effective and safe treatment for ECC. En bloc resection provides precise histologic information and prevention of tumor recurrence.
Adenoma/pathology/surgery
;
Adult
;
Aged
;
Aged, 80 and over
;
Colorectal Neoplasms/*epidemiology/pathology/surgery
;
Endoscopy, Gastrointestinal
;
Female
;
Follow-Up Studies
;
Humans
;
Intestinal Mucosa/*surgery
;
Male
;
Middle Aged
;
Neoplasm Invasiveness
;
Recurrence
;
Retrospective Studies
2.Follow-up Results of Endoscopic Mucosal Resection for Early Colorectal Cancer.
Hee Jung LEE ; Hyun Yong JEONG ; Nam Hwan PARK ; Sun Chang HONG ; Gwan Woo NAM ; Hee Seok MOON ; Eaum Seok LEE ; Seok Hyun KIM ; Jae Kyu SUNG ; Byung Seok LEE
The Korean Journal of Gastroenterology 2011;57(4):230-236
BACKGROUND/AIMS: Recently colonoscopy and screening programs have led to the detection and removal of increasing numbers of early colorectal cancer (ECC), which can reduce its related mortality. We analysed the clinical, endoscopic, and histologic findings, as well as the follow-up data, to evaluate the effectiveness and the long-term results of endoscopic mucosal resection (EMR) for ECC. METHODS: We analysed, retrospectively, 94 lesions in 92 patients who underwent EMR for ECC from January 2002 to June 2009. RESULTS: The overage age of patients was 60 years old. The mean follow-up period was 22.1 months (6-80). En bloc resection rate was 64.9%. Submucosal invasion was found in 30 cases (31.9%). De novo cancer rate was 26.6% which had higher submucosal invasion rate (60%, p=0.003). The complete resection rate was 87.2%, and there was no recurrence of cancer during follow-up (p=0.000). Twelve incomplete resection cases had received further surgical treatments. No procedure-related mortality was found and no recurrent malignancy was found except 1 case. CONCLUSIONS: This study shows that EMR is an effective and safe treatment for ECC. En bloc resection provides precise histologic information and prevention of tumor recurrence.
Adenoma/pathology/surgery
;
Adult
;
Aged
;
Aged, 80 and over
;
Colorectal Neoplasms/*epidemiology/pathology/surgery
;
Endoscopy, Gastrointestinal
;
Female
;
Follow-Up Studies
;
Humans
;
Intestinal Mucosa/*surgery
;
Male
;
Middle Aged
;
Neoplasm Invasiveness
;
Recurrence
;
Retrospective Studies
3.The Risk of Metachronous Advanced Colorectal Neoplasia Rises in Parallel with an Increasing Number of High-Risk Findings at Baseline.
Seung Min LEE ; Jeong Hwan KIM ; In Kyung SUNG ; Sung Noh HONG
Gut and Liver 2015;9(6):741-749
BACKGROUND/AIMS: Colorectal adenomas that are > or =10 mm have villous histology or high-grade dysplasia, or that are associated with > or =3 adenomas are considered high-risk for metachronous advanced neoplasia. We evaluated the cumulative incidence of metachronous advanced neoplasia according to the total number of high-risk findings detected on baseline colonoscopy. METHODS: This was a retrospective cohort study performed in 862 patients who underwent removal of colorectal adenomas between 2005 and 2009. At least one surveillance colonoscopy had been conducted at Konkuk University Medical Center, Seoul, Korea. RESULTS: The cumulative incidence of metachronous advanced neoplasia in patients with 0, 1, 2, and 3-4 high-risk findings at 1 year were 0.7%, 1.3%, 2.8%, and 8.0%; at 3 years, those were 5.9%, 11.9%, 15.5%, and 24.7%; and at 5 years, those were 8.5%, 18.7%, 26.3%, and 37.2%, respectively. In a multivariate model, the risk of metachronous advanced neoplasia was significantly higher for the multiple high-risk findings group when compared with the 0 high-risk findings group (1 high-risk (+): hazard ratio, 1.86 [95% confidence interval, 1.00-3.44]; 2 high-risk (+): 1.84 [0.88-3.84]; and 3-4 high-risk (+): 3.29 [1.54-7.01]; ptrend=0.020). CONCLUSIONS: The presence of overlapping multiple high-risk findings was associated with an increased risk of advanced neoplasia during surveillance.
Adenoma/epidemiology/*etiology/pathology
;
Aged
;
Colonic Polyps/complications/surgery
;
*Colonoscopy
;
Colorectal Neoplasms/epidemiology/*etiology/pathology
;
Early Detection of Cancer/methods
;
Female
;
Humans
;
Incidence
;
Male
;
Middle Aged
;
Neoplasm Grading
;
Neoplasms, Second Primary/epidemiology/*etiology/pathology
;
Population Surveillance/methods
;
Proportional Hazards Models
;
Republic of Korea/epidemiology
;
Retrospective Studies
;
Risk Factors
;
Time Factors
;
Tumor Burden