Local recurrence detection following transanal excision facilitated by EUS-FNA

Ferga C. Gleeson, David Larson, Eric Dozois, Lisa Allyn Boardman, Jonathan E. Clain, Elizabeth Rajan, Mark Topazian, Kenneth Ke Ning Wang, Michael J. Levy

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background/ Aims: Local excision is an alternative management approach for early rectal cancers and patients unfit for radical surgery. It is associated with a high local recurrence rate. Our aims were to evaluate the rate, pattern, method of local recurrence detection, the opportunity for salvage resection and finally to explore the utility of endoscopic ultrasound fine needle aspiration during surveillance. Methodology: A retrospective, non-controlled, cohort study from a single tertiary referral center comprised of patients under-going surveillance following a transanal excision. Results: Post-operative surveillance was performed in 155 transanal excision patients of which 46 (30%) underwent =1 endoscopic ultrasound examinations. Intra and extra luminal recurrence (n=16/24; (67%)) was detected more frequently in the endoscopic ultrasound surveillance population, p=0.0008. Mucosal scar biopsy (n=10/16;63%) and endoscopic ultrasound fine needle aspiration (6/16; 38%) of either a lymph node or the deep rectal wall were the methods for establishing local recurrence. An unremarkable proctoscopy with endoscopic ultrasound fine needle aspiration positive cytological findings was noted in 4 (9%) of the patients. Conclusions: Local recurrence following transanal excision is often in an intraluminal location. Endoscopic ultrasound fine needle aspiration confirmed nodal metastases in mesenteric and extra mesenteric locations more frequently than subepithelial locations.

Original languageEnglish (US)
Pages (from-to)1102-1107
Number of pages6
JournalHepato-Gastroenterology
Volume59
Issue number116
DOIs
StatePublished - Jun 2012

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Fine Needle Biopsy
Recurrence
Proctoscopy
Population Surveillance
Rectal Neoplasms
Tertiary Care Centers
Cicatrix
Cohort Studies
Lymph Nodes
Neoplasm Metastasis
Biopsy

Keywords

  • Endoscopic ultrasound fine needle aspiration
  • Local recurrence
  • Total mesorectal excision
  • Transanal excision

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Local recurrence detection following transanal excision facilitated by EUS-FNA. / Gleeson, Ferga C.; Larson, David; Dozois, Eric; Boardman, Lisa Allyn; Clain, Jonathan E.; Rajan, Elizabeth; Topazian, Mark; Wang, Kenneth Ke Ning; Levy, Michael J.

In: Hepato-Gastroenterology, Vol. 59, No. 116, 06.2012, p. 1102-1107.

Research output: Contribution to journalArticle

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abstract = "Background/ Aims: Local excision is an alternative management approach for early rectal cancers and patients unfit for radical surgery. It is associated with a high local recurrence rate. Our aims were to evaluate the rate, pattern, method of local recurrence detection, the opportunity for salvage resection and finally to explore the utility of endoscopic ultrasound fine needle aspiration during surveillance. Methodology: A retrospective, non-controlled, cohort study from a single tertiary referral center comprised of patients under-going surveillance following a transanal excision. Results: Post-operative surveillance was performed in 155 transanal excision patients of which 46 (30{\%}) underwent =1 endoscopic ultrasound examinations. Intra and extra luminal recurrence (n=16/24; (67{\%})) was detected more frequently in the endoscopic ultrasound surveillance population, p=0.0008. Mucosal scar biopsy (n=10/16;63{\%}) and endoscopic ultrasound fine needle aspiration (6/16; 38{\%}) of either a lymph node or the deep rectal wall were the methods for establishing local recurrence. An unremarkable proctoscopy with endoscopic ultrasound fine needle aspiration positive cytological findings was noted in 4 (9{\%}) of the patients. Conclusions: Local recurrence following transanal excision is often in an intraluminal location. Endoscopic ultrasound fine needle aspiration confirmed nodal metastases in mesenteric and extra mesenteric locations more frequently than subepithelial locations.",
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AU - Rajan, Elizabeth

AU - Topazian, Mark

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