title: Recurrent colorectal cancer after endoscopic resection when additional surgery was recommended.
abstract: OBJECTIVE
  To evaluate the type of recurrence after endoscopic resection in colorectal cancer patients and whether rescue was possible by salvage operation.
  
  
  METHODS
  Among 4972 patients who underwent surgical resection at our institution for primary or recurrent colorectal cancers from January 2005 to February 2015, we experienced eight recurrent colorectal cancers after endoscopic resection when additional surgical resection was recommended.
  
  
  RESULTS
  The recurrence patterns were: intramural local recurrence (five cases), regional lymph node recurrence (three cases), and associated with simultaneous distant metastasis (three cases). Among five cases with lymphatic invasion observed histologically in endoscopic resected specimens, four cases recurred with lymph node metastasis or distant metastasis. All cases were treated laparoscopically and curative surgery was achieved in six cases. Among four cases located in the rectum, three cases achieved preservation of the anus. Postoperative complications occurred in two cases (enteritis).
  
  
  CONCLUSIONS
  For high-risk submucosal invasive colorectal cancers after endoscopic resection, additional surgical resection with lymphadenectomy is recommended, particularly in cases with lymphovascular invasion.
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Takatsu
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fukunaga
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Hamasaki
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogura
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nagata
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Nagasaki
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiyoshi
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagayama
authors.affiliation: Yukiko Takatsu, Yosuke Fukunaga, Shunsuke Hamasaki, Atsushi Ogura, Jun Nagata, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno, Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003113:Colonoscopy / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003125:Colostomy; D005260:Female; D006801:Humans; D007564:Japan; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal neoplasms; Colorectal surgery; Endoscopy; Laparoscopy; Recurrence