Roel Bogie

Chapter 5

Recurrence rate of LNPCPs

160

Recurrence No Recurrence

140

No surveillance yet

120

100

80

60

40

Absolute numbers of LNPCPs

20

19%

16%

10%

0

6 months

12 months

3 years

Figure 5.2: Recurrence rate of LNPCPs in the regional screening cohort.

Table 5.3: Characteristics of interval cancers.

Interval cancer #1

Interval cancer #2

Size

20 mm Sessile Rectum

50 mm Sessile

Morphology

Location

Ascending colon Piecemeal EMR

Type of resection En-bloc EMR

Pathology

T1N0M0 adenocarcinoma Resection margin 0.1mm Kikuchi sm2 No lymphovascular invasion

Tubulovillous adenoma high-grade dysplasia

Initial lesion

Time to diagnosis 6 months

3 years Loss-to-follow-up (surveillance at 6 months has not been performed)

Diagnosed by

Endoscopy Surveillance

Endoscopy

Indication Treatment

Symptomatic iron deficiency

Transanal endoscopic microsurgery T2N0M0 adenocarcinoma R0-resection

Major surgery

Pathology

T2N0M0 No lymphovascular invasion

Interval cancer

Sequel

Wait and see at patient’s request 1 year later: metastasized disease

-

98