Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Dutch eFTR Group; Liselotte W Zwager; Barbara Bastiaansen; Bas van der Spek; Dimitri Heine; Ramon Michel Schreuder; Lars Perk; Bas L A M Weusten; Jurjen J Boonstra; Hedwig van der Sluis; Hugo J Wolters; Frank Bekkering; Svend T Rietdijk; M P Schwartz; Wouter B Nagengast; Rogier Ten Hove; Jochim S Terhaar Sive Droste; Francisco J Rando Munoz; Marije S Vlug; Hanneke Beaumont; Martin H M G Houben; Tom C J Seerden; Thomas de Wijkerslooth; Eric A R Gielisse; Yark Hazewinkel; Rogier de Ridder; Jan-Willem A Straathof; Manon van der Vlugt; L Koens; Paul Fockens; Evelien Dekker

doi:10.1055/a-1637-9051

Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Dutch eFTR Group
, Liselotte W Zwager
, Barbara Bastiaansen^*
, Bas van der Spek
, Dimitri Heine
, Ramon Michel Schreuder
, Lars Perk
, Bas L A M Weusten
, Jurjen J Boonstra
, Hedwig van der Sluis
, Hugo J Wolters
, Frank Bekkering
, Svend T Rietdijk
, M P Schwartz
, Wouter B Nagengast
, Rogier Ten Hove
, Jochim S Terhaar Sive Droste
, Francisco J Rando Munoz
, Marije S Vlug
, Hanneke Beaumont

Martin H M G Houben, Tom C J Seerden, Thomas de Wijkerslooth, Eric A R Gielisse, Yark Hazewinkel, Rogier de Ridder, Jan-Willem A Straathof, Manon van der Vlugt, L Koens, Paul Fockens, Evelien Dekker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

57 Citations (Scopus)

116 Downloads (Pure)

Abstract

BACKGROUND AND STUDY AIMS: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) is critical to determine subsequent treatment. Endoscopic Full-Thickness Resection (eFTR) is a new treatment option for T1 CRC <2cm. We aim to report clinical outcomes and short-term results.

PATIENTS AND METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analysed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk-assessment, curative resections, adverse events and short-term outcomes.

RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection and curative resection rates were 87.0% (95% CI [82.7 - 90.3%]), 85.6% (95% CI [81.2 - 89.2%]) and 60.3% (95% CI [54.7 - 65.7%]). Curative resection rate for primary resected T1 CRC was 23.7% (95% CI [15.9 - 33.6%]) and 60.8% (95% CI [50.4 - 70.4%]) after excluding deep submucosal invasion as risk-factor. Risk-stratification was possible in 99.3%. Severe adverse event rates was 2.2%. Additional oncologic surgery was performed in 49/320 (15.3%), with residual cancer in 11/49 (22.4%). Endoscopic follow-up was available in 200/242 (82.6%), with a median of 4 months and residual cancer in 1 (0.5%) following an incomplete resection.

CONCLUSIONS: eFTR is a relatively safe and effective method to resect small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

Original language	English
Pages (from-to)	475-485
Number of pages	11
Journal	Endoscopy
Volume	54
Issue number	05
DOIs	https://doi.org/10.1055/a-1637-9051
Publication status	Published - May-2022

Keywords

LONG-TERM OUTCOMES
SUBMUCOSAL DISSECTION
CLINICAL-OUTCOMES
MUCOSAL RESECTION
METAANALYSIS
RECOGNITION
MANAGEMENT
CARCINOMA
SOCIETY
LESIONS

Access to Document

10.1055/a-1637-9051

Endoscopic full-thickness resection of T1 colorectal cancersFinal publisher's version, 782 KBLicence: Taverne

Handle.net

Persistent link

Cite this

Dutch eFTR Group, Zwager, L. W., Bastiaansen, B., van der Spek, B., Heine, D., Schreuder, R. M., Perk, L., Weusten, B. L. A. M., Boonstra, J. J., van der Sluis, H., Wolters, H. J., Bekkering, F., Rietdijk, S. T., Schwartz, M. P., Nagengast, W. B., Ten Hove, R., Terhaar Sive Droste, J. S., Rando Munoz, F. J., Vlug, M. S., ... Dekker, E. (2022). Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry. Endoscopy, 54(05), 475-485. https://doi.org/10.1055/a-1637-9051

@article{bc0a16030ad9467e82f9af54610e7896,

title = "Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry",

abstract = "BACKGROUND AND STUDY AIMS: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) is critical to determine subsequent treatment. Endoscopic Full-Thickness Resection (eFTR) is a new treatment option for T1 CRC <2cm. We aim to report clinical outcomes and short-term results.PATIENTS AND METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analysed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk-assessment, curative resections, adverse events and short-term outcomes.RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection and curative resection rates were 87.0\% (95\% CI [82.7 - 90.3\%]), 85.6\% (95\% CI [81.2 - 89.2\%]) and 60.3\% (95\% CI [54.7 - 65.7\%]). Curative resection rate for primary resected T1 CRC was 23.7\% (95\% CI [15.9 - 33.6\%]) and 60.8\% (95\% CI [50.4 - 70.4\%]) after excluding deep submucosal invasion as risk-factor. Risk-stratification was possible in 99.3\%. Severe adverse event rates was 2.2\%. Additional oncologic surgery was performed in 49/320 (15.3\%), with residual cancer in 11/49 (22.4\%). Endoscopic follow-up was available in 200/242 (82.6\%), with a median of 4 months and residual cancer in 1 (0.5\%) following an incomplete resection.CONCLUSIONS: eFTR is a relatively safe and effective method to resect small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.",

keywords = "LONG-TERM OUTCOMES, SUBMUCOSAL DISSECTION, CLINICAL-OUTCOMES, MUCOSAL RESECTION, METAANALYSIS, RECOGNITION, MANAGEMENT, CARCINOMA, SOCIETY, LESIONS",

author = "\{Dutch eFTR Group\} and Zwager, \{Liselotte W\} and Barbara Bastiaansen and \{van der Spek\}, Bas and Dimitri Heine and Schreuder, \{Ramon Michel\} and Lars Perk and Weusten, \{Bas L A M\} and Boonstra, \{Jurjen J\} and \{van der Sluis\}, Hedwig and Wolters, \{Hugo J\} and Frank Bekkering and Rietdijk, \{Svend T\} and Schwartz, \{M P\} and Nagengast, \{Wouter B\} and \{Ten Hove\}, Rogier and \{Terhaar Sive Droste\}, \{Jochim S\} and \{Rando Munoz\}, \{Francisco J\} and Vlug, \{Marije S\} and Hanneke Beaumont and Houben, \{Martin H M G\} and Seerden, \{Tom C J\} and \{de Wijkerslooth\}, Thomas and Gielisse, \{Eric A R\} and Yark Hazewinkel and \{de Ridder\}, Rogier and Straathof, \{Jan-Willem A\} and \{van der Vlugt\}, Manon and L Koens and Paul Fockens and Evelien Dekker",

year = "2022",

month = may,

doi = "10.1055/a-1637-9051",

language = "English",

volume = "54",

pages = "475--485",

journal = "Endoscopy",

issn = "0013-726X",

publisher = "GEORG THIEME VERLAG KG",

number = "05",

}

Dutch eFTR Group, Zwager, LW, Bastiaansen, B, van der Spek, B, Heine, D, Schreuder, RM, Perk, L, Weusten, BLAM, Boonstra, JJ, van der Sluis, H, Wolters, HJ, Bekkering, F, Rietdijk, ST, Schwartz, MP, Nagengast, WB, Ten Hove, R, Terhaar Sive Droste, JS, Rando Munoz, FJ, Vlug, MS, Beaumont, H, Houben, MHMG, Seerden, TCJ, de Wijkerslooth, T, Gielisse, EAR, Hazewinkel, Y, de Ridder, R, Straathof, J-WA, van der Vlugt, M, Koens, L, Fockens, P & Dekker, E 2022, 'Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry', Endoscopy, vol. 54, no. 05, pp. 475-485. https://doi.org/10.1055/a-1637-9051

TY - JOUR

T1 - Endoscopic full-thickness resection of T1 colorectal cancers

T2 - a retrospective analysis from a multicenter Dutch eFTR registry

AU - Dutch eFTR Group

AU - Zwager, Liselotte W

AU - Bastiaansen, Barbara

AU - van der Spek, Bas

AU - Heine, Dimitri

AU - Schreuder, Ramon Michel

AU - Perk, Lars

AU - Weusten, Bas L A M

AU - Boonstra, Jurjen J

AU - van der Sluis, Hedwig

AU - Wolters, Hugo J

AU - Bekkering, Frank

AU - Rietdijk, Svend T

AU - Schwartz, M P

AU - Nagengast, Wouter B

AU - Ten Hove, Rogier

AU - Terhaar Sive Droste, Jochim S

AU - Rando Munoz, Francisco J

AU - Vlug, Marije S

AU - Beaumont, Hanneke

AU - Houben, Martin H M G

AU - Seerden, Tom C J

AU - de Wijkerslooth, Thomas

AU - Gielisse, Eric A R

AU - Hazewinkel, Yark

AU - de Ridder, Rogier

AU - Straathof, Jan-Willem A

AU - van der Vlugt, Manon

AU - Koens, L

AU - Fockens, Paul

AU - Dekker, Evelien

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND AND STUDY AIMS: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) is critical to determine subsequent treatment. Endoscopic Full-Thickness Resection (eFTR) is a new treatment option for T1 CRC <2cm. We aim to report clinical outcomes and short-term results.PATIENTS AND METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analysed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk-assessment, curative resections, adverse events and short-term outcomes.RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection and curative resection rates were 87.0% (95% CI [82.7 - 90.3%]), 85.6% (95% CI [81.2 - 89.2%]) and 60.3% (95% CI [54.7 - 65.7%]). Curative resection rate for primary resected T1 CRC was 23.7% (95% CI [15.9 - 33.6%]) and 60.8% (95% CI [50.4 - 70.4%]) after excluding deep submucosal invasion as risk-factor. Risk-stratification was possible in 99.3%. Severe adverse event rates was 2.2%. Additional oncologic surgery was performed in 49/320 (15.3%), with residual cancer in 11/49 (22.4%). Endoscopic follow-up was available in 200/242 (82.6%), with a median of 4 months and residual cancer in 1 (0.5%) following an incomplete resection.CONCLUSIONS: eFTR is a relatively safe and effective method to resect small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

AB - BACKGROUND AND STUDY AIMS: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) is critical to determine subsequent treatment. Endoscopic Full-Thickness Resection (eFTR) is a new treatment option for T1 CRC <2cm. We aim to report clinical outcomes and short-term results.PATIENTS AND METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analysed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk-assessment, curative resections, adverse events and short-term outcomes.RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection and curative resection rates were 87.0% (95% CI [82.7 - 90.3%]), 85.6% (95% CI [81.2 - 89.2%]) and 60.3% (95% CI [54.7 - 65.7%]). Curative resection rate for primary resected T1 CRC was 23.7% (95% CI [15.9 - 33.6%]) and 60.8% (95% CI [50.4 - 70.4%]) after excluding deep submucosal invasion as risk-factor. Risk-stratification was possible in 99.3%. Severe adverse event rates was 2.2%. Additional oncologic surgery was performed in 49/320 (15.3%), with residual cancer in 11/49 (22.4%). Endoscopic follow-up was available in 200/242 (82.6%), with a median of 4 months and residual cancer in 1 (0.5%) following an incomplete resection.CONCLUSIONS: eFTR is a relatively safe and effective method to resect small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

KW - LONG-TERM OUTCOMES

KW - SUBMUCOSAL DISSECTION

KW - CLINICAL-OUTCOMES

KW - MUCOSAL RESECTION

KW - METAANALYSIS

KW - RECOGNITION

KW - MANAGEMENT

KW - CARCINOMA

KW - SOCIETY

KW - LESIONS

U2 - 10.1055/a-1637-9051

DO - 10.1055/a-1637-9051

M3 - Article

C2 - 34488228

SN - 0013-726X

VL - 54

SP - 475

EP - 485

JO - Endoscopy

JF - Endoscopy

IS - 05

ER -

Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Abstract

Keywords

Access to Document

Handle.net

Fingerprint

Cite this