Clinical outcomes of positive resection margin after endoscopic mucosal resection of early colon cancers

박준석; 김현건; Shin Ok Jeong; Hoon gil Jo; Hyo Yeop Song; Jeeyeon Kim; Seri Ryu; Youngyun Cho; Hyun Jin Youn; Seong Ran Jeon; 김진오; 고봉민; 진윤미; 진소영

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자료유형: 학술저널

저자정보: 박준석 (순천향대학교) 김현건 (순천향대학교) Shin Ok Jeong (Soonchunhyang University Hospital) Hoon gil Jo (Soonchunhyang University College of Medicine) Hyo Yeop Song (Soonchunhyang University College of Medicine) Jeeyeon Kim (Soonchunhyang University College of Medicine) Seri Ryu (Soonchunhyang University College of Medicine) Youngyun Cho (Soonchunhyang University College of Medicine) Hyun Jin Youn (Soonchunhyang University College of Medicine) Seong Ran Jeon (Department of Internal Medicine Soonchunhyang University College of Medicine Seoul Korea) 김진오 (순천향대학교) 고봉민 (순천향대학교) 진윤미 (순천향대학교) 진소영 (순천향대학교)

저널정보: 대한장연구학회 Intestinal research Intestinal research Vol.17 No.4

발행연도: 2019.1

수록면: 516 - 526 (11page)

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Background/Aims: When determining the subsequent management after endoscopic resection of the early colon cancer (ECC), various factors including the margin status should be considered. This study assessed the subsequent management and outcomes of ECCs according to margin status. Methods: We examined the data of 223 ECCs treated by endoscopic mucosal resection (EMR) from 215 patients during 2004 to 2014, and all patients were followed-up at least for 2 years. Results: According to histological analyses, the margin statuses of all lesions after EMR were as follows: 138 cases (61.9%) were negative, 65 cases (29.1%) were positive for dysplastic cells on the resection margins, and 20 cases (8.9%) were uncertain. The decision regarding subsequent management was affected not only by pathologic outcomes but also by the endoscopist’s opinion on whether complete resection was obtained. Surgery was preferred if the lesion extended to the submucosa (odds ratio [OR], 25.46; 95% confidence interval [CI], 7.09–91.42), the endoscopic resection was presumed incomplete (OR, 15.55; 95% CI, 4.28–56.56), or the lymph system was invaded (OR, 13.69; 95% CI, 1.76–106.57). Fourteen patients (6.2%) had residual or recurrent malignancies at the site of the previous ECC resection and were significantly associated with presumed incomplete endoscopic resection (OR, 4.59; 95% CI, 1.21–17.39) and submucosal invasion (OR, 5.14; 95% CI, 1.18–22.34). Conclusions: Subsequent surgery was associated with submucosa invasion, lymphatic invasion, and cancer-positive margins. Presumed completeness of the resection may be helpful for guiding the subsequent management of patients who undergo endoscopic resection of ECC.

#Early colon cancer #Endosocpic mucosal resection #Margins of excision

참고문헌 (26)

참고문헌 신청

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박준석

소속기관 순천향대학교

주요연구분야 의약학 > 임상의학 > 내과학 의약학 > 임상의학 > 일반 외과학

논문수 3 이용수 2

김현건

소속기관 순천향대학교

주요연구분야 의약학 > 임상의학 > 내과학 의약학 > 임상의학 > 일반 외과학

논문수 19 이용수 65

Shin Ok Jeong

소속기관 Soonchunhyang University Hospital

주요연구분야 의약학 > 임상의학 > 내과학

논문수 1 이용수 0

Hoon gil Jo