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Diagnosis of Early Colorectal Carcinoma: Endoscopic Diagnosis and Classification

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Endoscopy in Early Gastrointestinal Cancers, Volume 1
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Abstract

Accurate endoscopic diagnosis of early colorectal cancer (CRC) is of utmost importance, as it can guide treatment in terms of endoscopic resection or surgery. Compared with surgery, endoluminal treatment can significantly reduce the length of hospital stay, or in some cases be performed as an outpatient procedure, as well as improve quality of life after treatment. It is, however, crucial to make a correct diagnosis prior to endoscopic resection to avoid undertreatment of deep invasive lesions with resultant post-colonoscopy colorectal cancer, which can have a poor prognosis. Modern endoscopic technology enables accurate determination of invasion depth of early CRC. This chapter will introduce the rationale and provide technical suggestions for the endoscopic diagnosis of early CRC.

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References

  1. Gunderson LL, Jessup JM, Sargent DJ, et al. Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol. 2010;28:256–63.

    Article  PubMed  Google Scholar 

  2. Gunderson LL, Jessup JM, Sargent DJ, et al. Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol. 2010;28:264–71.

    Article  PubMed  Google Scholar 

  3. Bosch SL, Teerenstra S, de Wilt JH, et al. Predicting lymph node metastasis in pT1 colorectal cancer: a systematic review of risk factors providing rationale for therapy decisions. Endoscopy. 2013;45:827–34.

    Article  PubMed  Google Scholar 

  4. Backes Y, de Vos Tot Nederveen Cappel WH, van Bergeijk J, et al. Risk for incomplete resection after macroscopic radical endoscopic resection of T1 colorectal cancer: a multicenter cohort study. Am J Gastroenterol. 2017;112:785–96.

    Article  CAS  PubMed  Google Scholar 

  5. Ikematsu H, Yoda Y, Matsuda T, et al. Long-term outcomes after resection for submucosal invasive colorectal cancers. Gastroenterology. 2013;144:551–9. quiz e14

    Google Scholar 

  6. Yoshii S, Nojima M, Nosho K, et al. Factors associated with risk for colorectal cancer recurrence after endoscopic resection of T1 tumors. Clin Gastroenterol Hepatol. 2014;12:292–302. e3

    Google Scholar 

  7. Tamaru Y, Oka S, Tanaka S, et al. Long-term outcomes after treatment for T1 colorectal carcinoma: a multicenter retrospective cohort study of Hiroshima GI Endoscopy Research Group. J Gastroenterol. 2017;52:1169–79.

    Article  PubMed  Google Scholar 

  8. Ikematsu H, Matsuda T, Emura F, et al. Efficacy of capillary pattern type IIIA/IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms. BMC Gastroenterol. 2010;10:33.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Fujii T, Hasegawa RT, Saitoh Y, et al. Chromoscopy during colonoscopy. Endoscopy. 2001;33:1036–41.

    CAS  PubMed  Google Scholar 

  10. Matsuda T, Saito Y, Fujii T, et al. Size does not determine the grade of malignancy of early invasive colorectal cancer. World J Gastroenterol. 2009;15:2708–13.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lambert R, Kudo SE, Vieth M, et al. Pragmatic classification of superficial neoplastic colorectal lesions. Gastrointest Endosc. 2009;70:1182–99.

    Article  PubMed  Google Scholar 

  12. Chiu HM, Lin JT, Chen CC, et al. Prevalence and characteristics of nonpolypoid colorectal neoplasm in an asymptomatic and average-risk Chinese population. Clin Gastroenterol Hepatol. 2009;7:463–70.

    Article  PubMed  Google Scholar 

  13. Matsuda T, Saito Y, Hotta K, et al. Prevalence and clinicopathological features of nonpolypoid colorectal neoplasms: should we pay more attention to identifying flat and depressed lesions? Dig Endosc. 2010;22(Suppl 1):S57–62.

    Article  PubMed  Google Scholar 

  14. Kim BC, Chang HJ, Han KS, et al. Clinicopathological differences of laterally spreading tumors of the colorectum according to gross appearance. Endoscopy. 2011;43:100–7.

    Article  CAS  PubMed  Google Scholar 

  15. Uraoka T, Saito Y, Matsuda T, et al. Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum. Gut. 2006;55:1592–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Yamada M, Saito Y, Sakamoto T, et al. Endoscopic predictors of deep submucosal invasion in colorectal laterally spreading tumors. Endoscopy. 2016;48:456–64.

    Article  PubMed  Google Scholar 

  17. Hayashi N, Tanaka S, Hewett DG, et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the narrow-band imaging international colorectal endoscopic (NICE) classification. Gastrointest Endosc. 2013;78:625–32.

    Article  PubMed  Google Scholar 

  18. Sano Y, Tanaka S, Kudo SE, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016;28:526–33.

    Article  PubMed  Google Scholar 

  19. Sumimoto K, Tanaka S, Shigita K, et al. Diagnostic performance of Japan NBI Expert Team classification for differentiation among noninvasive, superficially invasive, and deeply invasive colorectal neoplasia. Gastrointest Endosc. 2017;86:700–9.

    Article  PubMed  Google Scholar 

  20. Kudo S, Lambert R, Allen JI, et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc. 2008;68:S3–47.

    Article  PubMed  Google Scholar 

  21. Kudo S, Rubio CA, Teixeira CR, et al. Pit pattern in colorectal neoplasia: endoscopic magnifying view. Endoscopy. 2001;33:367–73.

    Article  CAS  PubMed  Google Scholar 

  22. Matsuda T, Fujii T, Saito Y, et al. Efficacy of the invasive/non-invasive pattern by magnifying chromoendoscopy to estimate the depth of invasion of early colorectal neoplasms. Am J Gastroenterol. 2008;103:2700–6.

    Article  PubMed  Google Scholar 

  23. Backes Y, Moss A, Reitsma JB, et al. Narrow band imaging, magnifying chromoendoscopy, and gross morphological features for the optical diagnosis of T1 colorectal cancer and deep submucosal invasion: a systematic review and meta-analysis. Am J Gastroenterol. 2017;112:54–64.

    Article  CAS  PubMed  Google Scholar 

  24. Sakamoto T, Saito Y, Nakajima T, et al. Comparison of magnifying chromoendoscopy and narrow-band imaging in estimation of early colorectal cancer invasion depth: a pilot study. Dig Endosc. 2011;23:118–23.

    Article  PubMed  Google Scholar 

  25. Puli SR, Bechtold ML, Reddy JB, et al. How good is endoscopic ultrasound in differentiating various T stages of rectal cancer? Meta-analysis and systematic review. Ann Surg Oncol. 2009;16:254–65.

    Article  PubMed  Google Scholar 

  26. Fu KI, Kato S, Sano Y, et al. Staging of early colorectal cancers: magnifying colonoscopy versus endoscopic ultrasonography for estimation of depth of invasion. Dig Dis Sci. 2008;53:1886–92.

    Article  PubMed  Google Scholar 

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Correspondence to Han Mo Chiu .

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Chiu, H.M. (2021). Diagnosis of Early Colorectal Carcinoma: Endoscopic Diagnosis and Classification. In: Chiu, P.W.Y., Sano, Y., Uedo, N., Singh, R. (eds) Endoscopy in Early Gastrointestinal Cancers, Volume 1. Springer, Singapore. https://doi.org/10.1007/978-981-10-6769-3_7

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  • DOI: https://doi.org/10.1007/978-981-10-6769-3_7

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6768-6

  • Online ISBN: 978-981-10-6769-3

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