{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:31Z","timestamp":1787004871472,"version":"build-2736575974"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neoplastic recurrence risk at scheduled surveillance intervals after colorectal endoscopic submucosal dissection (ESD), as well as its association with histologic risk features, is unclear, resulting in uncertainty for post-ESD surveillance recommendations. We conducted a systematic review and meta-analysis of 1-, 3-, and 5-year post-ESD neoplastic recurrence with subgroup analyses.<\/jats:p>\n                  <jats:p>A systematic search was performed up until October 2025. Eligible studies were assessed for neoplastic recurrence at or near the resection site at 1-, 3-, and 5-year scheduled surveillance colonoscopies. Rates of metachronous neoplastic lesions at the same time-intervals were also collected. Data were pooled using a random-effects model, and subgroup analyses were conducted for histology of the index lesion (low or high grade dysplasia, and T1 cancer) and resection quality (R0 vs. non-R0).<\/jats:p>\n                  <jats:p>10 studies encompassing 5306 lesions met the inclusion criteria. The pooled R0 resection rate was 82% (95%CI 79%\u201385%). Overall neoplastic recurrence rates were low and stable over time: 1.2% (95%CI 0.4%\u20132.6%), 1.4% (95%CI 1.0%\u20131.9%), and 1.9% (95%CI 0.9%\u20133.1%) at 1, 3, and 5 years, respectively. Malignant recurrence was rare (0.2%) and confined to noncurative resections or deep submucosal invasion. The pooled rate of metachronous lesions was 1.4% (95%CI 0.4%\u20133.0%). Limited time-stratified data suggest progressive accrual of metachronous neoplasia during follow-up rather than early post-ESD failure.<\/jats:p>\n                  <jats:p>Neoplastic recurrence is rare up to the 5-year endoscopic surveillance, especially in those with R0 resection and favorable histology. In low risk patients, an extended surveillance interval of up to 5 years can be considered, mostly because of an increased risk of metachronous lesions.<\/jats:p>","DOI":"10.1055\/a-2875-1254","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T23:13:47Z","timestamp":1778541227000},"source":"Crossref","is-referenced-by-count":1,"title":["Neoplastic recurrence after colorectal endoscopic submucosal dissection at scheduled endoscopic surveillance: a systematic review and meta-analysis"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-7806","authenticated-orcid":false,"given":"Daryl","family":"Ramai","sequence":"additional","affiliation":[{"name":"The University of Utah School of Medicine, Utah, United States","place":["Salt Lake City"],"department":["Division of Gastroenterology, Hepatology, and 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Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Warner","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Ohio, United States","place":["Cincinnati"],"department":["Academic & Research Services Librarian"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azizullah","family":"Beran","sequence":"additional","affiliation":[{"name":"Indiana University, Indiana, United States","place":["Bloomington"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6448-2649","authenticated-orcid":false,"given":"Roberto","family":"De Sire","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]},{"name":"Universit\u00e0 degli Studi di Napoli Federico II, Italy","place":["Napoli"],"department":["Gastroenterology, IBD Unit, Department of Clinical Medicine and Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-1459","authenticated-orcid":false,"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Italy","place":["Rozzano"],"department":["Digestive Endoscopy Unit"]},{"name":"Humanitas University, Italy","place":["Milan"],"department":["Department of Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Aihara","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Massachusetts, United States","place":["Boston"],"department":["Division of Gastroenterology, Hepatology and 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