Endoscopic therapy for early colorectal cancer：a retrospective study

Abstract

Appropriate treatment options for early colorectal cancer (ECRC) smaller than 20 mm remains controversial. Here, we studied the efficacy and safety of endoscopic therapy for ECRC smaller than 20 mm. About 191 patients with colorectal lesions entered into our study from January 2017 to December 2019. Lesions were divided into two groups according to sizes: smaller than 10 mm group and 10-20 mm group. Most cases of ECRC were found in the left colon (70.15%), and the male to female ratio was 1.81:1. A very smaller proportion of colorectal lesions smaller than 10 mm in size were submucosal carcinoma (0.077%), whereas 3.85% of colorectal lesions between 10 mm and 20 mm in size were submucosal carcinoma (P=0.049). Cold snare polypectomy (CSP) was found to be a safe and efficient for lesions smaller than 10 mm. For the lesions smaller than 10 mm, the rate of en bloc resection reached 100%, whereas only 81.82% of the lesions of 10-20 mm in size could be resected en bloc and for these cases, endoscopic mucosal resection (EMR) were better therapeutic options. Endoscopic CSP is an appropriate therapeutic approach for ECRC of less than 10 mm in size, whereas for lesions smaller than 10 mm in size but with submucosal infiltration, EMR should be considered. For submucosal carcinoma (SM-carcinoma), endoscopic submucosal dissection (ESD) or surgery should be considered as better options.