ENDOSCOPIC THERAPEUTICS AND DIAGNOSTICS FOR COLON CANCER: AN UPDATE AND FUTURE PERSPECTIVE

Ishtiaq Ur-Rahman, Chen Zhang, Ya-Bin Qi, Ruo-Bing Hu, Kuan Li, Lu Xu, Xiao-Ting Li, Abdun Mohammed Awadh, Jing Ma1, Wei Xiao and Song-Ze Ding*

ABSTRACT

Colorectal cancer is the third most commonly diagnosed malignancy and it afflicts approximately 1 million people around the globe each year. Before the era of national screening programs, the majority of colon cancers were diagnosed at an advanced stage, which required major surgery and led to significant morbidity and mortality rates. Currently, cancer screening programs are not only established, but also widely accepted across the globe. The widespread use of modern endoscopes permits the detection of cancers in early stages, with a low risk of lymph node metastases or distant spread. Endoscopic approaches demonstrated their superiority over conventional surgical techniques and created a precedent for minimally invasive operations for early colon cancer. Subsequently, with improved technology, many patients with colon cancer worldwide have undergone endoscopic resection and this technique has become the standard of care for early colon cancer. Early-stage colon cancer is defined as a disease that appears to have been completely resected without involvement of adjacent organs, lymph nodes, or distant sites. Endoscopic mucosal resection and endoscopic submucosal dissection have been used for early colon cancer, however, recently a more advanced therapeutic endoscopy technique endoscopic full-thickness resection has also been introduced as a therapeutic option for advanced colonic cancer resection. This article provides an overview of the available endoscopic therapeutics for colon cancer and the diagnostics role of endoscopic ultrasound, with a perspective on recent advances, and also sheds light on the safety, indications, and complications for each endoscopic resection approach for colon cancer.

Keywords: Colon cancer; Early stage colon cancer; Advanced colon cancer; Endoscopic therapeutics; Endoscopic resection techniques.