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4 results on '"Dutch eFTR Grp"'

1. Endoscopic full-thickness resection of T1 colorectal cancers:a retrospective analysis from a multicenter Dutch eFTR registry

Author

Zwager, L.W., Bastiaansen, B.A.J., Spek, B.W. van der, Heine, D.N., Schreuder, R.M., Perk, L.E., Weusten, B.L.A.M., Boonstra, J.J., Sluis, H. van der, Wolters, H.J., Bekkering, F.C., Rietdijk, S.T., Schwartz, M.P., Nagengast, W.B., Hove, W.R. ten, Droste, J.S.T.S., Munoz, F.J.R., Vlug, M.S., Beaumont, H., Houben, M.H.M.G., Seerden, T.C.J., Wijkerslooth, T.R. de, Gielisse, E.A.R., Hazewinkel, Y., Ridder, R. de, Straathof, J.W.A., Vlugt, M. van der, Koens, L., Fockens, P., Dekker, E., Dutch eFTR Grp, Graduate School, Tytgat Institute for Liver and Intestinal Research, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Pathology, Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), RS: FHML non-thematic output, Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Gastroenterology and hepatology

Subjects
CLINICAL-OUTCOMES, medicine.medical_specialty, Future studies, CARCINOMA, Colorectal cancer, Residual cancer, MUCOSAL RESECTION, SOCIETY, Oncologic surgery, SUBMUCOSAL DISSECTION, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], LONG-TERM OUTCOMES, MANAGEMENT, Retrospective analysis, Medicine, Full thickness resection, Adverse effect, METAANALYSIS, LESIONS, business.industry, RECOGNITION, Gastroenterology, medicine.disease, Surgery, Clinical trial, business
Abstract

Background Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC Methods Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes. Results We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %–90.3 %), 85.6 % (95 %CI 81.2 %–89.2 %), and 60.3 % (95 %CI 54.7 %–65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %–33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %–70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection. Conclusions eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

Published
2022
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2. Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Author

Zwager, Liselotte W, Zwager, Liselotte W, Bastiaansen, Barbara A J, van der Spek, Bas W, Heine, Dimitri N, Schreuder, Ramon M, Perk, Lars E, Weusten, Bas L A M, Boonstra, Jurjen J, van der Sluis, Hedwig, Wolters, Hugo J, Bekkering, Frank C, Rietdijk, Svend T, Schwartz, Matthijs P, Nagengast, Wouter B, Ten Hove, W Rogier, Terhaar Sive Droste, Jochim S, Rando Munoz, Francisco J, Vlug, Marije S, Beaumont, Hanneke, Houben, Martin H M G, Seerden, Tom C J, de Wijkerslooth, Thomas R, Gielisse, Eric A R, Hazewinkel, Yark, de Ridder, Rogier, Straathof, Jan-Willem A, van der Vlugt, Manon, Koens, Lianne, Fockens, Paul, Dekker, Evelien, Dutch eFTR Grp, Zwager, Liselotte W, Zwager, Liselotte W, Bastiaansen, Barbara A J, van der Spek, Bas W, Heine, Dimitri N, Schreuder, Ramon M, Perk, Lars E, Weusten, Bas L A M, Boonstra, Jurjen J, van der Sluis, Hedwig, Wolters, Hugo J, Bekkering, Frank C, Rietdijk, Svend T, Schwartz, Matthijs P, Nagengast, Wouter B, Ten Hove, W Rogier, Terhaar Sive Droste, Jochim S, Rando Munoz, Francisco J, Vlug, Marije S, Beaumont, Hanneke, Houben, Martin H M G, Seerden, Tom C J, de Wijkerslooth, Thomas R, Gielisse, Eric A R, Hazewinkel, Yark, de Ridder, Rogier, Straathof, Jan-Willem A, van der Vlugt, Manon, Koens, Lianne, Fockens, Paul, Dekker, Evelien, and Dutch eFTR Grp

Abstract

BACKGROUND: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC < 2 cm. We aimed to report clinical outcomes and short-term results.METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes.RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %-90.3 %), 85.6 % (95 %CI 81.2 %-89.2 %), and 60.3 % (95 %CI 54.7 %-65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %-33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %-70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection.CONCLUSIONS: eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

Published
2022

3. Endoscopic full-thickness resection (eFTR) of colorectal lesions: results from the Dutch colorectal eFTR registry

Author

Zwager, L.W., Bastiaansen, B.A.J., Bronzwaer, M.E.S., Spek, B.W. van der, Heine, G.D.N., Haasnoot, K.J.C., Sluis, H. van der, Perk, L.E., Boonstra, J.J., Rietdijk, S.T., Wolters, H.J., Weusten, B.L.A.M., Gilissen, L.P.L., Hove, W.R. ten, Nagengast, W.B., Bekkering, F.C., Schwartz, M.P., Droste, J.S.T.S., Vlug, M.S., Houben, M.H.M.G., Munoz, F.J.R., Seerden, T.C.J., Beaumont, H., Ridder, R. de, Dekker, E., Fockens, P., Dutch eFTR Grp, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Gastroenterology and hepatology, Graduate School, Tytgat Institute for Liver and Intestinal Research, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, APH - Quality of Care, Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), and RS: FHML non-thematic output

Subjects
medicine.medical_specialty, Colorectal cancer, SUBMUCOSAL DISSECTION, 03 medical and health sciences, 0302 clinical medicine, medicine, Full thickness resection, Adverse effect, METAANALYSIS, OUTCOMES, medicine.diagnostic_test, business.industry, EMR, Gastroenterology, En bloc resection, Retrospective cohort study, medicine.disease, CANCER, Appendicitis, Surgery, Endoscopy, Clinical trial, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, ADVERSE EVENTS, business, NEOPLASMS
Abstract

Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesions ≤ 30 mm unsuitable for conventional endoscopic resection. This study reports clinical outcomes from the Dutch colorectal eFTR registry. Methods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events. Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), re-resection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9 %). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4 %) and full-thickness resection in 288 (83.2 %). The median diameter of resected specimens was 23 mm. Overall adverse event rate was 9.3 % (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis. Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.

Published
2020
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4. Endoscopic full-thickness resection (eFTR) of colorectal lesions: results from the Dutch colorectal eFTR registry

Author

Zwager, Liselotte W., Zwager, Liselotte W., Bastiaansen, Barbara A. J., Bronzwaer, Maxime E. S., van der Spek, Bas W., Heine, G. Dimitri N., Haasnoot, Krijn J. C., van der Sluis, Hedwig, Perk, Lars E., Boonstra, Jurjen J., Rietdijk, Svend T., Wolters, Hugo J., Weusten, Bas L. A. M., Gilissen, Lennard P. L., Ten Hove, W. Rogier, Nagengast, Wouter B., Bekkering, Frank C., Schwartz, M. P., Droste, Jochim S. Terhaar Sive, Vlug, Marije S., Houben, Martin H. M. G., Munoz, Francisco J. Rando, Seerden, Tom C. J., Beaumont, Hanneke, de Ridder, Rogier, Dekker, Evelien, Fockens, Paul, Dutch eFTR Grp, Zwager, Liselotte W., Zwager, Liselotte W., Bastiaansen, Barbara A. J., Bronzwaer, Maxime E. S., van der Spek, Bas W., Heine, G. Dimitri N., Haasnoot, Krijn J. C., van der Sluis, Hedwig, Perk, Lars E., Boonstra, Jurjen J., Rietdijk, Svend T., Wolters, Hugo J., Weusten, Bas L. A. M., Gilissen, Lennard P. L., Ten Hove, W. Rogier, Nagengast, Wouter B., Bekkering, Frank C., Schwartz, M. P., Droste, Jochim S. Terhaar Sive, Vlug, Marije S., Houben, Martin H. M. G., Munoz, Francisco J. Rando, Seerden, Tom C. J., Beaumont, Hanneke, de Ridder, Rogier, Dekker, Evelien, Fockens, Paul, and Dutch eFTR Grp

Abstract

Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesionsMethods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events.Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), reresection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9%). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4%) and full-thickness resection in 288 (83.2%). The median diameter of resected specimens was 23mm. Overall adverse event rate was 9.3% (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis.Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.

Published
2020

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