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Clinical outcomes and factors related to resectability and curability of EMR for early colorectal can

 Jae Jun Park  ;  Jae Hee Cheon  ;  Ji Eun Kwon  ;  Jae Kook Shin  ;  Soung Min Jeon  ;  Hyun Jung Bok  ;  Jin Ha Lee  ;  Chang Mo Moon  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Hoguen Kim  ;  Won Ho Kim 
 GASTROINTESTINAL ENDOSCOPY, Vol.74(6) : 1337-1346, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Colonoscopy/methods* ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/surgery* ; Dissection/methods* ; Early Diagnosis* ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Intestinal Mucosa/pathology ; Intestinal Mucosa/surgery* ; Male ; Middle Aged ; Neoplasm Staging* ; Retrospective Studies ; Time Factors ; Treatment Outcome
ECC ; early colorectal cancer ; ESD ; endoscopic submucosal dissection
BACKGROUND: EMR has emerged as an alternative therapeutic option for selected cases of early colorectal cancer (ECC). However, the factors associated with resectability and curability of EMR for ECC remain unknown.

OBJECTIVE: To investigate clinical outcomes and factors related to resectability and curability in ECC cases treated with EMR.

DESIGN: Retrospective study.

SETTING: Tertiary-care academic medical center.

PATIENTS: This study involved all patients in whom EMR was performed for ECC at Severance Hospital between March 1997 and August 2007. A total of 236 cases of ECC occurring in 231 patients (66.2% men) were enrolled.

INTERVENTION: EMR. Curative surgical resection and lymph node dissection were used in cases that were incompletely cured by EMR.

MAIN OUTCOME MEASUREMENTS: Resectability, curability, and recurrence.

RESULTS: Complete cure was achieved for 162 lesions (68.6%). Of the remaining 74 cases (31.4%), 69 (29.2%) were incompletely cured, and the other 5 (2.1%) had an undetermined resection status and ultimately required supplementary surgical resection for curative treatment. Location on the right side of the colon, piecemeal resection, and submucosal carcinoma were independently associated with incomplete resection, whereas depressed tumor type was independently related to incomplete cure. Among the ECC cases completely cured by EMR and followed for more than a year (n = 118), local recurrence was observed in one case (0.8%) during the median follow-up period of 39.4 months (range 12.4-123.1 months).

LIMITATIONS: Single-center, retrospective study.

CONCLUSION: Our data show that EMR is feasible and could be an effective option for treatment of ECC if the technique is applied with the appropriate indications.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji Eun(권지은)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Kim, Hogeun(김호근)
Moon, Chang Mo(문창모)
Park, Jae Jun(박재준)
Bok, Hyun Jung(복현정)
Shin, Jae Kook(신재국)
Jeon, Soung Min(전승민)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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