Early Colorectal Cancer Treated by Endoscopic Mucosal Resection
Methods 129 early colorectal cancer (ECC) patients who were initially treated by EMR between April 2005 and August 2007 were enrolled. Clinicopathological characteristics and prognosis were evaluated retrospectively. Results En-bloc resection was performed in 85% of ECC patients and piece-meal resection in 15% of patients. Clear lateral and deep margins achieved in 86% of cases. Of 129 patients, 64 showed intramucosal cancer and 65 submucosal cancer. Clinical characteristics were not different between patients with intramucosal cancer and submucosal cancer, however, poor-differentiation and the absence of background adenoma showed significant association with submucosal cancer.
7 patients with submucosal cancer underwent subsequent surgical resection; 5 had lymphovascular invasion or positive resection margin, 1 perforation, and 1 patient's request. Of these 7 patients, 1 had residual cancer and 2 had lymph node metastasis. All patients with intramucosal cancer showed no recurrence during the follow-up period. 7 patients with submucosal cancer showed adverse outcomes within 3 years, such as residual/recurrence of primary cancer or lymph node metastasis; 5 showed lymphovascular invasion or positive deep margin, and 2 had no histological risk factors.
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7 patients with submucosal cancer underwent subsequent surgical resection; 5 had lymphovascular invasion or positive resection margin, 1 perforation, and 1 patient's request. Of these 7 patients, 1 had residual cancer and 2 had lymph node metastasis. All patients with intramucosal cancer showed no recurrence during the follow-up period. 7 patients with submucosal cancer showed adverse outcomes within 3 years, such as residual/recurrence of primary cancer or lymph node metastasis; 5 showed lymphovascular invasion or positive deep margin, and 2 had no histological risk factors.
