Byun Jeong-sik, a professor of gastroenterology at Asan Medical Center in Seoul, performs endoscopic resection. Photo courtesy of Asan Medical Center, Seoul
There is no difference in survival rate between surgery and immediate surgery if necessary after surgery
Among early colorectal cancers, if it is unclear whether lymph node metastasis is or not, the results of a study showed that performing an endoscopy first instead of an immediate surgery is a safe way to treat the patient while improving the quality of life.
The team led by Professor Jeongsik Byun and Donghoon Yang of the Department of Gastroenterology at the Colorectal Cancer Center, Asan Medical Center Cancer Hospital, Seoul reviewed the treatment results of patients who underwent endoscopic resection and those who underwent immediate surgery among patients undergoing surgery for early colorectal cancer with suspected lymph node metastasis. Follow-up for 5 years.
As a result, the 5-year cancer recurrence-free survival rate of cancer-free survival was 98.5% in the group that underwent endoscopic resection first and 97% in the group that underwent immediate surgery, indicating that there was no statistically significant difference.
Endoscopic resection for early colorectal cancer is being actively performed because there is no incision site to excise the cancer by inserting an endoscope through the anus, there is little pain after the procedure, and there are few changes in bowel habits or other complications. However, it can be cured only if there is no lymph node metastasis, and if there is already lymph node metastasis, surgery to remove the colon is necessary.
Because early colorectal cancer is difficult to accurately diagnose whether it has spread to the lymph nodes, endoscopic resection is often performed first, followed by additional surgery to determine whether metastasis has occurred. Until now, concerns have been raised that endoscopic resection may delay the treatment time and increase the risk of cancer recurrence by touching the cancerous tissue.
This study revealed that when treating early colorectal cancer, even if lymph node metastasis is ambiguous, it is safe enough to try endoscopic resection as much as possible while maintaining the patient’s quality of life.
Professor Byun Jeong-sik of Gastroenterology explained, “Even after endoscopic resection, we were able to achieve similar treatment results compared to the case of surgery from the beginning because of the close cooperation system with excellent colorectal and anal surgeons.”
The research results were recently published in the international scientific journal ‘Gastrointestinal Endoscopy (IF=9.427)’.
Reporter Jae-beom Kim, Donga Sports Donga oldfield@donga.com See more articles from reporters
