Predictive factors of local recurrence after endoscopic piecemeal mucosal resection.
BACKGROUND
Endoscopic piecemeal mucosal resection (EPMR) is a widely accepted treatment for colorectal tumefaction. However, as it is associated with a significant recurrence rate, the technique remains controversial. The purpose of our study was to evaluate the risk factors for the local recurrence of colorectal neoplasms after EPMR.


METHODS
The study population of our retrospective evaluation comprised 222 patients who had undergone EPMR from January 2002 to July 2007 and who had had at least 1 surveillance colonoscopy 3-6 months after the initial treatment.


RESULTS
Local recurrence was detected in 42 patients (19%) between 6 and 15 months after EPMR. Our multivariate analysis revealed that the resection of 5 or more neoplasm specimens, compared with fewer than 5, was 3 times more likely to result in local recurrence (P = 0.005). No statistically significant correlation of local recurrence with lesion size, location, macroscopic type, or histology was detected.


CONCLUSIONS
The removal of 5 or more neoplasm specimens is an independent risk factor for local recurrence after EPMR. Careful colonoscopic surveillance should be performed after multiple piecemeal resection.
Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan. tasakamo@ncc.go.jp
Taku
T
Sakamoto
Takahisa
T
Matsuda
Yosuke
Y
Otake
Takeshi
T
Nakajima
Yutaka
Y
Saito
D000368:Aged; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D018365:Neoplasm, Residual / Q000209:etiology; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome