Local recurrence after endoscopic resection of sessile serrated lesions: A multicenter prospective study by the Osaka Gut Forum
Satoki Shichijo
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorShinjiro Yamaguchi
Department of Gastroenterology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
Search for more papers by this authorDai Nakamatsu
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
Search for more papers by this authorTakanori Inoue
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorMasanori Nakahara
Department of Gastroenterology, Ikeda Municipal Hospital, Osaka, Japan
Search for more papers by this authorHideharu Ogiyama
Department of Gastroenterology, Itami City Hospital, Itami, Hyogo, Japan
Search for more papers by this authorTakuya Yamada
Department of Gastroenterology, Osaka Rosai Hospital, Osaka, Japan
Search for more papers by this authorKazuro Kinoshita
Department of Gastroenterology, Otemae Hospital, Osaka, Japan
Search for more papers by this authorRyu Ishihara
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorTomoki Michida
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorTsutomu Nishida
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
Search for more papers by this authorYoshiki Tsujii
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYoshito Hayashi
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShinichiro Shinzaki
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKeisuke Fukui
Center for Cancer Control and Statistics, Osaka International Cancer Institute, Osaka, Japan
Department of Mathematics Program, Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorYuri Ito
Center for Cancer Control and Statistics, Osaka International Cancer Institute, Osaka, Japan
Department of Medical Statistics, Research and Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
Search for more papers by this authorMasanori Kitamura
Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorKeiichiro Honma
Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorEiichi Morii
Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorCorresponding Author
Tetsuo Takehara
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Correspondence
Tetsuo Takehara, MD, PhD, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Email: [email protected]
Search for more papers by this authorthe Osaka Gut Forum
Search for more papers by this authorSatoki Shichijo
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorShinjiro Yamaguchi
Department of Gastroenterology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
Search for more papers by this authorDai Nakamatsu
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
Search for more papers by this authorTakanori Inoue
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorMasanori Nakahara
Department of Gastroenterology, Ikeda Municipal Hospital, Osaka, Japan
Search for more papers by this authorHideharu Ogiyama
Department of Gastroenterology, Itami City Hospital, Itami, Hyogo, Japan
Search for more papers by this authorTakuya Yamada
Department of Gastroenterology, Osaka Rosai Hospital, Osaka, Japan
Search for more papers by this authorKazuro Kinoshita
Department of Gastroenterology, Otemae Hospital, Osaka, Japan
Search for more papers by this authorRyu Ishihara
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorTomoki Michida
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorTsutomu Nishida
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
Search for more papers by this authorYoshiki Tsujii
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorYoshito Hayashi
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorShinichiro Shinzaki
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorKeisuke Fukui
Center for Cancer Control and Statistics, Osaka International Cancer Institute, Osaka, Japan
Department of Mathematics Program, Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorYuri Ito
Center for Cancer Control and Statistics, Osaka International Cancer Institute, Osaka, Japan
Department of Medical Statistics, Research and Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
Search for more papers by this authorMasanori Kitamura
Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorKeiichiro Honma
Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorEiichi Morii
Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
Search for more papers by this authorCorresponding Author
Tetsuo Takehara
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
Correspondence
Tetsuo Takehara, MD, PhD, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Email: [email protected]
Search for more papers by this authorthe Osaka Gut Forum
Search for more papers by this authorAbstract
Background and Aim
Sessile serrated lesions (SSLs) act as precursors to colorectal cancer, sometimes harbor carcinomas, and are sometimes incompletely resected. We aimed to evaluate local recurrence after endoscopic resection of SSL ≥10 mm.
Methods
This prospective, single-arm, observational study was performed at eight Japanese tertiary institutions. Colorectal lesions ≥10 mm were resected endoscopically, and the pathological diagnosis was either an SSL or hyperplastic polyp (HP). Follow-up colonoscopy was performed 1 year later, and the local recurrence was evaluated by biopsy.
Results
From October 2018 to September 2021, 104 cases with 123 lesions were registered. Among the pathologically diagnosed 105 SSLs and 18 HPs, 95 and 7 lesions were diagnosed as SSLs and HPs, respectively, by central pathological review. Among the 104 endoscopically diagnosed SSLs, 86 were diagnosed as SSLs, whereas among the 11 endoscopically diagnosed HPs, two were diagnosed as HPs by central pathological review (the rest were SSLs). Among the 95 patients with 113 lesions who underwent follow-up colonoscopy, resection scars were identified in 95 (84%) lesions. Three (3.1%; 95% confidence interval 0.6–8.7%) local recurrences were diagnosed pathologically among 98 pathologically diagnosed SSLs. Two (6%) local recurrences were diagnosed in patients with SSLs ≥20 mm.
Conclusions
The local recurrence rate after endoscopic resection of SSLs ≥10 mm was 3.1%. Careful follow-up is recommended after endoscopic resection of large SSLs. Endoscopically diagnosed HPs ≥10 mm were sometimes pathologically diagnosed as SSL and should be considered for resection.
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