title: Local recurrence after endoscopic resection of colorectal tumors.
abstract: OBJECTIVE
  Local recurrence frequently occurs after endoscopic resection of large colorectal tumors. However, appropriate intervals for surveillance colonoscopy to assess local recurrence after endoscopic resection have not been clarified. The aim of the present study was to determine local recurrence rates following en-bloc and piecemeal endoscopic resection and establish appropriate surveillance colonoscopy intervals based on retrospective analysis of local recurrences.
  
  
  METHODS
  A total of 461 patients with 572 > or = 10-mm lesions underwent endoscopic resection and follow-up. We retrospectively compared local recurrence rates on lesion size, macroscopic type, and histological type after en-bloc resection (440 lesions) and piecemeal resection (132 lesions). Cumulative local recurrence rates were analyzed using the Kaplan-Meier method.
  
  
  RESULTS
  Local recurrence occurred for 34 lesions (5.9%). Local recurrence rates for the en-bloc and piecemeal groups was 0.7% (3/440) and 23.5% (31/132), respectively (P < 0.001). The difference between the two groups was distinct in terms of lesion size, macroscopic type, and histological type. Of the 34 local recurrences, 32 were treated endoscopically and two cases required additional surgery. The 6-, 12-, and 24-month cumulative local recurrence rate of the en-bloc group was 0.24%, 0.49%, and 0.81%. Then the 6-, 12-, and 24-month cumulative local recurrence rate for the piecemeal group was 18.4%, 23.1%, and 30.7%.
  
  
  CONCLUSIONS
  Local recurrence occurred more frequently after piecemeal resection than en-bloc resection. However, almost all cases of local recurrences could be cured by additional endoscopic resection, so piecemeal resection can be acceptable treatment.
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. kinichi1@janis.or.jp
authors.forename: Kinichi
authors.initials: K
authors.lastname: Hotta
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fujii
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*