Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline

• Published in: Endoscopy Vol. 51; no. 3; pp. 266 - 277
• Main Authors: Hassan, Cesare, Wysocki, Piotr Tomasz, Fuccio, Lorenzo, Seufferlein, Thomas, Dinis-Ribeiro, Mário, Brandão, Catarina, Regula, Jaroslaw, Frazzoni, Leonardo, Pellise, Maria, Alfieri, Sergio, Dekker, Evelien, Jover, Rodrigo, Rosati, Gerardo, Senore, Carlo, Spada, Cristiano, Gralnek, Ian, Dumonceau, Jean-Marc, van Hooft, Jeanin E., van Cutsem, Eric, Ponchon, Thierry
• Format: Journal Article
• Language: English
• Published: Stuttgart · New York Georg Thieme Verlag KG 01.03.2019
• Subjects: Colonoscopy - standards; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Endoscopic Mucosal Resection; Europe; Guideline; Humans; Population Surveillance; Europe
• ISSN: 0013-726X; 1438-8812
• DOI: 10.1055/a-0831-2522

Main Recommendations 1  We recommend post-surgery endoscopic surveillance for CRC patients after intent-to-cure surgery and appropriate oncological treatment for both local and distant disease. Strong recommendation, low quality evidence. 2  We recommend a high quality perioperative colonoscopy before surgery for CRC or within 6 months following surgery. Strong recommendation, low quality evidence. 3  We recommend performing surveillance colonoscopy 1 year after CRC surgery. Strong recommendation, moderate quality evidence. 4  We do not recommend an intensive endoscopic surveillance strategy, e. g. annual colonoscopy, because of a lack of proven benefit. Strong recommendation, moderate quality evidence. 5  After the first surveillance colonoscopy following CRC surgery, we suggest the second colonoscopy should be performed 3 years later, and the third 5 years after the second. If additional high risk neoplastic lesions are detected, subsequent surveillance examinations at shorter intervals may be considered. Weak recommendation, low quality evidence. 6  After the initial surveillance colonoscopy, we suggest halting post-surgery endoscopic surveillance at the age of 80 years, or earlier if life-expectancy is thought to be limited by comorbidities. Weak recommendation, low quality evidence. 7  In patients with a low risk pT1 CRC treated by endoscopy with an R0 resection, we suggest the same endoscopic surveillance schedule as for any CRC. Weak recommendation, low quality evidence.