When cancer comes back after surgery, the usual fix is another operation. But for one man, doctors tried something less invasive: a combined scope procedure that removed the tumor from the inside, without a single cut on his belly.
The 61-year-old had already had rectal cancer surgery. Then a new tumor appeared in his transverse colon. Instead of standard surgery, he underwent a laparoscopic-endoscopic cooperative full-thickness resection. That means doctors used a camera and a scope to remove the entire thickness of the colon wall where the cancer was.
The removed tissue showed a moderately differentiated adenocarcinoma that had grown into the subserosa, the outer layer of the colon. That's stage pT3. But the margins were clean, meaning no cancer cells were left behind. The tumor had low-grade budding, no invasion into lymph or blood vessels, and normal mismatch repair proteins.
At 21 months, there was no sign of the cancer coming back. That's encouraging, but this is just one person's story. Doctors can't be sure no cancer cells are hiding in nearby lymph nodes. So this approach is not a replacement for standard cancer surgery. It's a possible option for certain patients, but more research is needed.
Common questions
What is laparoscopic-endoscopic cooperative full-thickness resection?
It's a procedure that combines a laparoscope (a small camera through a tiny cut) and an endoscope (a tube through the mouth or anus) to remove a tumor from the colon wall. In this case, it removed the full thickness of the colon where the cancer was, without a large abdominal incision.
Is this procedure a replacement for standard colon cancer surgery?
No. The report clearly states it should not be considered an alternative to standard oncologic surgery. Standard surgery also removes nearby lymph nodes to check for spread. This technique doesn't do that, so it's not for everyone.
What were the findings after the tumor was removed?
The tumor was a moderately differentiated adenocarcinoma that had grown into the subserosa (pT3). The margins were negative, meaning no cancer cells at the edges. There was low-grade tumor budding, no lymphovascular or perineural invasion, and normal mismatch repair proteins.
Did the cancer come back after this procedure?
In this case, no recurrence was detected at 21 months of follow-up. However, this is just one patient, and the report notes that occult nodal disease (cancer in lymph nodes that isn't visible) cannot be excluded.
