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Endoscopic resection of superficial colorectal tumors: Are our histoprognostic criteria sufficient?

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2022. Ressources en ligne : Abrégé : En-bloc endoscopic resection is the standard treatment for superficial colorectal cancers because it provides oncological efficacy comparable to surgery with lower morbidity and mortality. This resection is said to be curative when the risk of lymph node invasion is negligible, i.e., when a certain number of histoprognostic criteria are met (free lateral and deep margins, absence of lympho-vascular emboli or tumor budding, good/moderate degree of differentiation, and depth of submucosal invasion < 1,000 μm). The absence of only one of these criteria should theoretically lead to additional surgery with lymph node dissection. The current problem is that the “weight” of each of its histoprognostic criteria is probably not equivalent in terms of the risk of lymph node invasion, and their improvement could in turn help improve certain decision-making aspects during our multidisciplinary meetings. In this article, we will discuss the “lymph node weight” of each of these criteria as well as the prospects for improving our histoprognostic criteria.
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En-bloc endoscopic resection is the standard treatment for superficial colorectal cancers because it provides oncological efficacy comparable to surgery with lower morbidity and mortality. This resection is said to be curative when the risk of lymph node invasion is negligible, i.e., when a certain number of histoprognostic criteria are met (free lateral and deep margins, absence of lympho-vascular emboli or tumor budding, good/moderate degree of differentiation, and depth of submucosal invasion < 1,000 μm). The absence of only one of these criteria should theoretically lead to additional surgery with lymph node dissection. The current problem is that the “weight” of each of its histoprognostic criteria is probably not equivalent in terms of the risk of lymph node invasion, and their improvement could in turn help improve certain decision-making aspects during our multidisciplinary meetings. In this article, we will discuss the “lymph node weight” of each of these criteria as well as the prospects for improving our histoprognostic criteria.

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