Efficacy of endoscopic submucosal dissection in treating early colorectal cancer and precancerous lesions.

Purpose: To compare the efficacy and safety between endoscopic submucosal dissection (ESD) and conventional surgical treatment in the treatment of colorectal cancer (CRC) and the precancerous lesions.

Methods: A retrospective analysis was performed on the clinical data of 65 patients with CRC or precancerous lesions (ESD group) and another 65 patients receiving surgical treatment at the same period (Surgery group). The surgical indicators, incidence of complications, and quality of life score were compared between the two groups, and the survival and tumor progression were followed up and recorded.

Results: The rate of en bloc tumor resection was 89.2% (58/65) and 100% (65/65) and the rate of tumor curative resection was 92.3% (60/65) and 100% (65/65) in ESD group and Surgery group. Moreover, ESD group had markedly shorter operation time and mean hospital stay. After treatment, ESD group had higher scores of emotional functioning, fatigue, constipation, and diarrhea symptoms and general quality of life on the European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC QLQ-C30) than Surgery group. The follow-up results showed no statistically significant difference in the 5-year recurrence rate between ESD group and Surgery group (7.7% vs. 0%, p=0.208).

Conclusion: ESD and surgery have similar long-term clinical efficacy in treating early CRC and precancerous lesions, but ESD is more minimally invasive and safer, and is superior in accelerating postoperative recovery and improving the overall survival of patients.