Long-Term Outcomes of Endoscopic Submucosal Dissection for Colorectal Epithelial Neoplasms: A Systematic Review

Toshihiro Nishizawa; Takashi Ueda; Hirotoshi Ebinuma; Osamu Toyoshima; Hidekazu Suzuki

doi:10.3390/cancers15010239

Long-Term Outcomes of Endoscopic Submucosal Dissection for Colorectal Epithelial Neoplasms: A Systematic Review

Cancers (Basel). 2022 Dec 30;15(1):239. doi: 10.3390/cancers15010239.

Authors

Toshihiro Nishizawa^{1

2}, Takashi Ueda³, Hirotoshi Ebinuma¹, Osamu Toyoshima², Hidekazu Suzuki³

Affiliations

¹ Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan.
² Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan.
³ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.

Abstract

In this review, we summarize up-to-date reports with five-year observation after colorectal endoscopic submucosal dissection (ESD). Five-year cause-specific survival rates ranged from 98.6 to 100%. The local recurrence rates ranged from 1.1 to 2.2% in complete resection and 7.5 to 25.0% in incomplete resection. Incomplete resection was a risk factor for local recurrence. In non-curative ESD, five-year cause-specific survival rates ranged from 93.8 to 100% with additional surgery, and 92.7 to 99.1% without surgery. The choice of additional surgery should be based on the individual patient's age, concomitant diseases, wishes, life expectancy, and the risk of lymph node metastasis. The metachronous cancer rates ranged from 0.22 to 1.1%. Both local recurrence and metachronous tumors should be checked with a follow-up colonoscopy after ESD.

Keywords: colorectal; endoscopic submucosal dissection; long-term outcomes.

Publication types

Review

Grants and funding

This work was partially supported by a Grant from Japan Agency for Medical Research and Development (AMED) (to Suzuki H) and by a Grant-in-Aid for Scientific Research B (20H03667, to Suzuki H). The author Suzuki H received scholarship funds for research from Daiichi-Sankyo, Otsuka Pharm. Co, Ltd., MSD Co., Tanabe Pharm. Co., and Takeda Pharm. Co. and received service honoraria from AbbVie Inc., Astellas Pharm, Biofermin Pharm. Co., EA Pharma Co., Ltd., Janssen Pharm. K.K., Otsuka Pharm Co., Takeda Pharm Co., Tsumura Co. and Viatris Co.