Advertisement

Colorectum: Mucosal Neoplasias

  • Andrej Wagner
  • Tadateru Maehata
  • Frieder BerrEmail author
  • Naohisa Yahagi
Chapter

Abstract

To minimize the risk for interval cancer after colonoscopy, we need to improve detection of small (<10 mm) and minute (<5 mm) flat-type neoplasias and inconspicuous laterally spreading tumors, and we aim to analyze neoplasias for risk of superficial or invasive cancer. Currently, endoscopic en bloc resection yields poor curative resection rates outside East Asia, mainly owing to non-exclusion of deep sm2–3 invasive colorectal cancer lesions. Therefore, we focus on endoscopic distinction of benign lesions versus malignant neoplasias, and of superficial versus deep submucosa-invasive (sm2–3) early colorectal cancer; both distinctions are required to determine indications for endoscopic en bloc resection or surgery.

Keywords

Early colorectal neoplasias Vessel pattern Surface/pit pattern Adenomas, serrated and classic Adenocarcinoma Lateral spreading tumors Submucosal cancer invasion Endoscopic resection, indications Surgical resection, indications 

Notes

Acknowledgments

We gratefully acknowledge the contribution of some cases by Dr. Tsuneo Oyama of Nagano, Japan, and the contribution of histology by Dr. Daniel Neureiter and Dr. Tobias Kiesslich, Salzburg, Austria.

References

  1. 1.
    O’Brien MJ, et al. Flat adenomas in the National Polyp Study: Is there increased risk for high-grade dysplasia initially or during surveillance? Clin Gastroenterol Hepatol. 2004;2:905–11.CrossRefGoogle Scholar
  2. 2.
    The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58:S3–43.Google Scholar
  3. 3.
    Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005;37:570–8.CrossRefGoogle Scholar
  4. 4.
    George SM, et al. Classification of advanced colorectal carcinomas by tumor edge morphology: evidence for different pathogenesis and significance of polypoid and nonpolypoid tumors. Cancer. 2000;89:1901–9.CrossRefGoogle Scholar
  5. 5.
    Kudo S, et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc. 2008;68:S3–47.CrossRefGoogle Scholar
  6. 6.
    Rembacken BJ, et al. Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK. Lancet. 2000;355:1211–4.CrossRefGoogle Scholar
  7. 7.
    Fuccio L, et al. Clinical outcomes after endoscopic submucosal dissection for colorectal neoplasia: a systematic review and meta-analysis. Gastrointest Endosc. 2017;86:74–86.CrossRefGoogle Scholar
  8. 8.
    Kaminski MF, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. United European Gastroenterol J. 2017;5:309–34.CrossRefGoogle Scholar
  9. 9.
    Rotondano G, et al. The Cooperative Italian FLIN Study Group: prevalence and clinico-pathological features of colorectal laterally spreading tumors. Endoscopy. 2011;43:856–61.CrossRefGoogle Scholar
  10. 10.
    Soetikno RM, et al. Prevalence of nonpolypoid (flat and depressed) colorectal neoplasms in asymptomatic and symptomatic adults. JAMA. 2008;299:1027–35.CrossRefGoogle Scholar
  11. 11.
    Bogie RM, et al. Endoscopic subtypes of colorectal laterally spreading tumors (LSTs) and the risk of submucosal invasion: a meta-analysis. Endoscopy. 2018;50:263–82.CrossRefGoogle Scholar
  12. 12.
    Matsuda T, et al. Our perspective on endoscopic resection for colorectal neoplasms. Gastroenterol Clin Biol. 2010;34:367–70.CrossRefGoogle Scholar
  13. 13.
    Niimi K, et al. Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy. 2010;42:723–9.CrossRefGoogle Scholar
  14. 14.
    Kudo S, et al. Pit pattern in colorectal neoplasia: endoscopic magnifying view. Endoscopy. 2001;33:367–73.CrossRefGoogle Scholar
  15. 15.
    Sano Y, et al. Magnifying observation of microvascular architecture of colorectal lesions using a narrow-band imaging system. Dig Endosc. 2006;18:s44–51.CrossRefGoogle Scholar
  16. 16.
    Hayashi N, et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification. Gastrointest Endosc. 2013;78:625–32.CrossRefGoogle Scholar
  17. 17.
    Sano Y, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016;28:526–33.CrossRefGoogle Scholar
  18. 18.
    Komeda Y, et al. Magnifying narrow band imaging (NBI) for the diagnosis of localized colorectal lesions using the Japan NBI Expert Team (JNET) Classification. Oncology. 2017;93(Suppl 1):49–54.CrossRefGoogle Scholar
  19. 19.
    Wada Y, et al. Diagnostic accuracy of pit pattern and vascular pattern analyses in colorectal lesions. Dig Endosc. 2010;22:192–9.CrossRefGoogle Scholar
  20. 20.
    Matsuda T, et al. Efficacy of the invasive/non-invasive pattern by magnifying chromoendoscopy to estimate the depth of invasion of early colorectal neoplasms. Am J Gastroenterol. 2008;103:2700–6.CrossRefGoogle Scholar
  21. 21.
    Backes Y, et al. Narrow band imaging, magnifying chromoendoscopy, and gross morphological features for the optical diagnosis of T1 colorectal cancer and deep submucosal invasion: a systematic review and meta-analysis. Am J Gastroenterol. 2017;112:54–64.CrossRefGoogle Scholar
  22. 22.
    Zhang QW, et al. Narrow-band imaging in the diagnosis of deep submucosal colorectal cancers: a systematic review and meta-analysis. Endoscopy. 2017;49:564–80.CrossRefGoogle Scholar
  23. 23.
    Tanaka S, et al. JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc. 2015;27:417–34.CrossRefGoogle Scholar
  24. 24.
    East JE, et al. Serrated lesions in colorectal cancer screening: detection, resection, pathology and surveillance. Gut. 2015;64:991–1000.CrossRefGoogle Scholar
  25. 25.
    Hazewinkel Y, et al. Endoscopic features of sessile serrated adenomas: validation by international experts using high-resolution white-light endoscopy and narrow-band imaging. Gastrointest Endosc. 2013;77:916–24.CrossRefGoogle Scholar
  26. 26.
    Ijspeert JE, et al. Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut. 2016;65:963–70.CrossRefGoogle Scholar
  27. 27.
    Ijspeert JE, et al. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut. 2017;66:1225–32.CrossRefGoogle Scholar
  28. 28.
    Kanao H, et al. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc. 2009;69:631–6.CrossRefGoogle Scholar
  29. 29.
    Rondagh EJ, et al. Nonpolypoid colorectal neoplasms: a challenge in endoscopic surveillance of patients with Lynch syndrome. Endoscopy. 2013;45:257–64.CrossRefGoogle Scholar
  30. 30.
    De Jong AE, et al. The role of mismatch repair gene defects in the development of adenomas in patients with HNPCC. Gastroenterology. 2004;126:42–8.CrossRefGoogle Scholar
  31. 31.
    Vasen HF, et al. Familial colorectal cancer risk: ESMO clinical recommendations. Ann Oncol. 2009;20(Suppl 4):51–3.PubMedGoogle Scholar
  32. 32.
    Kato H, et al. Lifting of lesions during endoscopic mucosal resection (EMR) of early colorectal cancer: implications for the assessment of resectability. Endoscopy. 2001;33:568–73.CrossRefGoogle Scholar
  33. 33.
    Uraoka T, et al. Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum. Gut. 2006;55:1592–7.CrossRefGoogle Scholar
  34. 34.
    Kimura T, et al. A novel pit pattern identifies the precursor of colorectal cancer derived from sessile serrated adenoma. Am J Gastroenterol. 2012;107:460–9.CrossRefGoogle Scholar
  35. 35.
    Morita T, et al. Evaluation of endoscopic and histopathological features of serrated adenoma of the colon. Endoscopy. 2001;33:761–5.CrossRefGoogle Scholar
  36. 36.
    Uraoka T, et al. Prospective evaluation of endoscopic criteria characteristic of sessile serrated adenomas/polyps. J Gastroenterol. 2015;50:555–63.CrossRefGoogle Scholar
  37. 37.
    Yano Y, et al. Clinicopathological and molecular features of colorectal serrated neoplasias with different mucosal crypt patterns. Am J Gastroenterol. 2011;106:1351–8.CrossRefGoogle Scholar
  38. 38.
    Miwata T, et al. Clinicopathologic features of hyperplastic/serrated polyposis syndrome in Japan. J Gastroenterol Hepatol. 2013;28:1693–8.CrossRefGoogle Scholar
  39. 39.
    Rutter MD, et al. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps. Gut. 2015;64:1847–73.CrossRefGoogle Scholar
  40. 40.
    Ferlitsch M, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2017;49:270–97.CrossRefGoogle Scholar
  41. 41.
    Cao Y, et al. Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract. Endoscopy. 2009;41:751–7.CrossRefGoogle Scholar
  42. 42.
    Hochdorffer R, et al. Endoscopic resection of “giant” colorectal lesions: long-term outcome and safety. Z Gastroenterol. 2010;48:741–7.CrossRefGoogle Scholar
  43. 43.
    Saito Y, et al. Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors as determined by curative resection. Surg Endosc. 2010;24:343–52.CrossRefGoogle Scholar
  44. 44.
    Saito Y, et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc. 2010;72:1217–25.CrossRefGoogle Scholar
  45. 45.
    Yahagi N, et al. Endoscopic submucosal dissection for the reliable en bloc resection of colorectal mucosal tumors. Dig Endosc. 2004;16:s89–92.CrossRefGoogle Scholar
  46. 46.
    Kitajima K, et al. Correlations between lymph node metastasis and depth of submucosal invasion in colorectal carcinoma: J Gastroenterol. 2004;39:534–43.Google Scholar
  47. 47.
    Watanabe T, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol. 2018;23:1–34.CrossRefGoogle Scholar
  48. 48.
    Long KC, et al. Screening, surveillance, and treatment of anal intraepithelial neoplasia. Clin Colon Rectal Surg. 2016;29:57–64.CrossRefGoogle Scholar
  49. 49.
    Wagner A, et al. Endoscopic submucosal dissection (ESD) for anal high-grade intraepithelial dysplasia: a case report. Z Gastroenterol. 2018;56:495–8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing 2019

Authors and Affiliations

  • Andrej Wagner
    • 1
  • Tadateru Maehata
    • 2
  • Frieder Berr
    • 3
    Email author
  • Naohisa Yahagi
    • 2
  1. 1.Department of Internal Medicine IUniversity Hospital, Paracelsus Medical UniversitySalzburgAustria
  2. 2.Division of Research and Development for Minimally Invasive Treatment, Cancer CenterKeio University School of MedicineShinjuku-kuJapan
  3. 3.Department of Internal Medicine IParacelsus Medical UniversitySalzburgAustria

Personalised recommendations