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Management of Non-curative Resection and Local Recurrence after Endoscopic Resection

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Endoscopy in Early Gastrointestinal Cancers, Volume 2

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Abstract

Herein, we describe the management of non-curative resection and local recurrence after endoscopic resection (ER) for colorectal neoplasms. Non-curative resection is indicated when (1) the resection is incomplete (i.e., apparent or inconclusive tumor involvement is seen on the resected margin of the specimen) and (2) the removed specimen does not fulfill the curative criteria. After incomplete resection, if the horizontal margin is positive or inconclusive, including piecemeal resection, careful surveillance is mandatory, and endoscopic submucosal dissection or underwater endoscopic mucosal resection can be a promising salvage therapy for recurrent lesions after ER. Non-curative criteria for colorectal neoplasms are lesions invading a depth of ≥1000 μm or lesions with lymphovascular involvement, poorly differentiated/signet-ring cell/mucinous carcinoma, or budding grades 2 and 3 (high-risk submucosally invasive cancer); and surgical colorectomy with lymph node dissection is indicated. Endoscopists should know how to appropriately manage these lesions since ER is not always perfect.

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Authors and Affiliations

  1. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Otemae, Chuo-ku, Osaka, Japan

    Yoji Takeuchi, Noriya Uedo & Ryu Ishihara

Authors
  1. Yoji Takeuchi
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  2. Noriya Uedo
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  3. Ryu Ishihara
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Corresponding author

Correspondence to Yoji Takeuchi .

Editor information

Editors and Affiliations

  1. Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Philip W. Y. Chiu

  2. Gastrointestinal Center & Institute of minimally-invasive endoscopic care, Sano Hospital, Kobe, Hyogo, Japan

    Yasushi Sano

  3. Department of Gastrointestinal Oncology, Endoscopy Training and Learning Center, Osaka Medical Center for Cancer & Cardiovascular Diseases, Higashinari-ku, Osaka, Japan

    Noriya Uedo

  4. Gastroenterology Department, Lyell McEwin Hospital, Adelaide, SA, Australia

    Rajvinder Singh

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Takeuchi, Y., Uedo, N., Ishihara, R. (2021). Management of Non-curative Resection and Local Recurrence after Endoscopic Resection. In: Chiu, P.W.Y., Sano, Y., Uedo, N., Singh, R. (eds) Endoscopy in Early Gastrointestinal Cancers, Volume 2. Springer, Singapore. https://doi.org/10.1007/978-981-10-6778-5_16

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  • DOI: https://doi.org/10.1007/978-981-10-6778-5_16

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6777-8

  • Online ISBN: 978-981-10-6778-5

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