{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:51:10Z","timestamp":1777225870334,"version":"3.51.4"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>\n            Background\u2002During endoscopic submucosal dissection (ESD), the normal mucosa is cut under constant optical control. We studied whether a positive horizontal resection margin after a complete en bloc ESD predicts local recurrence.<\/jats:p><jats:p>\n            Methods\u2002In this European multicenter cohort study, patients with a complete en bloc colorectal ESD were selected from prospective registries. Cases were defined by a horizontal resection margin that was positive or indeterminate for dysplasia (HM1), whereas controls had a free resection margin (HM0). Low risk lesions with submucosal invasion (T1) and margins free of carcinoma were analyzed separately. The main outcome was local recurrence.<\/jats:p><jats:p>\n            Results\u2002From 928 consecutive ESDs (2011\u20132020), 354 patients (40\u200a% female; mean age 67 years, median follow-up 23.6 months), with 308 noninvasive lesions and 46 T1 lesions, were included. The recurrence rate for noninvasive lesions was 1\/212 (0.5\u200a%; 95\u200a%CI 0.02\u200a%\u20132.6\u200a%) for HM0 vs. 2\/96 (2.1\u200a%; 95\u200a%CI 0.57\u200a%\u20137.3\u200a%) for HM1.\u200aThe recurrence rate for T1 lesions was 1\/38 (2.6\u200a%; 95\u200a%CI 0.14\u200a%\u201313.5\u200a%) for HM0 vs. 2\/8 (25\u200a%; 95\u200a%CI 7.2\u200a%\u201359.1\u200a%) for HM1.<\/jats:p><jats:p>\n            Conclusion\u2002A positive horizontal resection margin after an en bloc ESD for noninvasive lesions is associated with a marginal nonsignificant increase in the local recurrence rate, equal to an ESD with clear horizontal margins. This could not be confirmed for T1 lesions.<\/jats:p>","DOI":"10.1055\/a-1960-3552","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T22:52:55Z","timestamp":1665701575000},"page":"245-251","source":"Crossref","is-referenced-by-count":8,"title":["Low risk of local recurrence after a successful en bloc endoscopic submucosal dissection for noninvasive colorectal lesions with positive horizontal resection margins (R-ESD study)"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8581-7906","authenticated-orcid":false,"given":"Krijn J. C.","family":"Haasnoot","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-1945","authenticated-orcid":false,"given":"Francisco","family":"Baldaque-Silva","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Center for Upper Digestive Diseases, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden"},{"name":"Pedro Hispano Hospital, Advanced Endoscopy Center Carlos Moreira da Silva, Porto, Portugal"}]},{"given":"Arjun","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands"}]},{"given":"Mariana","family":"Figueiredo Ferreira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0614-0576","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Santos-Antunes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Center of S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"IPATIMUP\/i3S, University of Porto, Porto, Portugal"}]},{"given":"Emanuel","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Center of S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Masami","family":"Omae","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Center for Upper Digestive Diseases, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1341-0044","authenticated-orcid":false,"given":"Laurelle","family":"van Tilburg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5502-4980","authenticated-orcid":false,"given":"Hao","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6256-0167","authenticated-orcid":false,"given":"Arnaud","family":"Lemmers","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}]},{"given":"Jurjen J.","family":"Boonstra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands"}]},{"given":"Leon M. G.","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands"}]}],"member":"194","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1055\/s-0034-1364970","article-title":"Local recurrence after endoscopic mucosal resection of nonpedunculated colorectal lesions: Systematic review and meta-analysis","volume":"46","author":"T DG Belderbos","year":"2014","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s00428-016-2055-1","article-title":"Endoscopic submucosal dissection specimens in early colorectal cancer: lateral margins, macroscopic techniques, and possible pitfalls","volume":"470","author":"A Dessain","year":"2017","journal-title":"Virchows 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