European Society of Gastrointestinal Endoscopy

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

Authors: Cesare Hassan, Piotr Tomasz Wysocki, Lorenzo Fuccio, Thomas Seufferlein, Mário Dinis-Ribeiro, Catarina Brandão, Jaroslaw Regula, Leonardo Frazzoni, Maria Pellise, Sergio Alfieri, Evelien Dekker, Rodrigo Jover, Gerardo Rosati, Carlo Senore, Cristiano Spada, Ian Gralnek, Jean-Marc Dumonceau, Jeanin E. van Hooft, Eric van Cutsem, Thierry Ponchon

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.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.

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

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DOI https://doi.org/10.1055/a-0831-2522
Endoscopy 2019; 51: 266–277
© Georg Thieme Verlag KG Stuttgart· New York