{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:43:21Z","timestamp":1793425401472,"version":"4.5.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background and study aims\u2002Many studies have reported on laterally spreading tumors (LSTs), but systematic reviews of the data to determine their risk of containing submucosal invasion (SMI) are lacking. We systematically screened and analyzed the available literature to provide a more solid basis for evidence-based treatment.<\/jats:p>\n                  <jats:p>Methods\u2002We conducted a systematic search in PubMed, Embase, the Cochrane Library, and Scopus for published articles until July 2017.\u200aWe estimated pooled prevalence or odds ratios (ORs) with 95\u200a% confidence intervals (CIs), using random-effects models. We classified endoscopic subtypes into granular LST, which comprises the homogeneous and nodular mixed subtypes, and non-granular LST, which comprises the flat elevated and pseudodepressed subtypes.<\/jats:p>\n                  <jats:p>Results\u2002We identified 2949 studies, of which 48 were included. Overall, 8.5\u200a% (95\u200a%CI 6.5\u200a%\u200a\u2013\u200a10.5\u200a%) of LSTs contained SMI. The risk of SMI differed among the LST subtypes: 31.6\u200a% in non-granular pseudodepressed LSTs (95\u200a%CI 19.8\u200a%\u200a\u2013\u200a43.4\u200a%), 10.5\u200a% in granular nodular mixed LSTs (95\u200a%CI 5.9\u200a%\u200a\u2013\u200a15.1\u200a%), 4.9\u200a% in non-granular flat elevated LSTs (95\u200a%CI 2.1\u200a%\u200a\u2013\u200a7.8\u200a%), and 0.5\u200a% in granular homogenous LSTs (95\u200a%CI 0.1\u200a%\u200a\u2013\u200a1.0\u200a%). SMI was more common in distally rather than in proximally located LSTs (OR 2.50, 95\u200a%CI 1.24\u200a\u2013\u200a5.02). The proportion of SMI increased with lesion size (10\u200a\u2013\u200a19\u200amm, 4.6\u200a%; 20\u200a\u2013\u200a29\u200amm, 9.2\u200a%;\u200a\u2265\u200a30\u200amm, 16.5\u200a%). The pooled prevalence of patients with one or more LSTs in the general colonoscopy population was 0.8\u200a% (95\u200a%CI 0.6\u200a%\u200a\u2013\u200a1.1\u200a%).<\/jats:p>\n                  <jats:p>Conclusion\u2002The majority of LSTs are non-invasive at the time of colonoscopic detection and can be treated with (piecemeal) endoscopic mucosal resection. Pretreatment diagnosis of endoscopic subtype, specifying areas of concern (nodule or depression), determines those LSTs at highest risk of containing SMI, where en bloc resection is the preferred therapy.<\/jats:p>","DOI":"10.1055\/s-0043-121144","type":"journal-article","created":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T18:46:19Z","timestamp":1511808379000},"page":"263-282","source":"Crossref","is-referenced-by-count":113,"title":["Endoscopic subtypes of colorectal laterally spreading tumors (LSTs) and the risk of submucosal invasion: a meta-analysis"],"prefix":"10.1055","volume":"50","author":[{"given":"Roel","family":"Bogie","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Veldman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Snijders","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Winkens","sequence":"additional","affiliation":[{"name":"Department of Methodology and Statistics, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"CAPHRI, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya","family":"Kaltenbach","sequence":"additional","affiliation":[{"name":"Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA"},{"name":"Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad","family":"Masclee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveline","family":"Rondagh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Soetikno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore"},{"name":"National Cancer Center Singapore, Singapore"},{"name":"Duke \u2013 National University Singapore Graduate Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Mo","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Sanduleanu-Dascalescu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,11,27]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-121144.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T07:52:18Z","timestamp":1550562738000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-121144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,27]]},"references-count":0,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2018,2,26]]},"published-print":{"date-parts":[[2018,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-121144","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,27]]}}}