Predictors of recurrence of superficial epithelial neoplasms of the colon after their endoscopic removal

Abstract

Based on current data on the risks of recurrence of colon epithelial neoplasms after their endoscopic removal, it is advisable to identify its predictors, which was the aim of our study. The study included 668 patients, who underwent endoscopic resection of superficial colonic epithelial neoplasms in the Nizhny Novgorod Regional Oncology Dispensary from 2012 to 2020. The study included patients who were diagnosed with large epithelial benign and malignant (with an invasion depth within the mucosa) neoplasms of the colon measuring 20 mm or more. Their average size was 35.5 ± 0.68 mm (median - 30 mm). During data analysis, we identified factors, associated with an increased risk of recurrence of epithelial neoplasms after their intraluminal endoscopic resection. First of all, these include the localization of the tumor in the descending colon and rectum, as well as its elevated flat type (type IIa according to the Paris classification). The histological type of the neoplasm - moderately differentiated adenocarcinoma, is also reliably associated with a high risk of its recurrence. The use of ESD, completed by endoscopic loop resection, increases the risk of developing a residual tumor threefold. According to our data on the absence of local relapse after the modified ESD “String-to-ring”, we consider it appropriate to further use this technique in everyday practice, especially for the removal high-risk neoplasms.