Surveillance Intervals After Piecemeal Resection of Non-pedunculated Colorectal Lesions ≥20mm

Launched by ASOCIACIÓN ESPAÑOLA DE GASTROENTEROLOGÍA · Jan 19, 2025

Keywords

ClinConnect Summary

The SCARFACE clinical trial is studying whether a less frequent follow-up schedule after the removal of certain large colorectal lesions can still effectively catch any recurrences. Currently, patients usually have check-ups at 6, 12, and 48 months after their treatment, but this trial will compare that standard approach to a reduced schedule with follow-ups only at 12 and 48 months. The hope is that the less frequent check-ups will be just as effective, while also reducing the number of procedures patients undergo, which can be uncomfortable and costly.

To participate in this trial, patients should have had a single large colorectal lesion (at least 20 mm) removed and treated to prevent recurrence. They also need to have had a thorough colonoscopy within the last six months and must be willing to sign an informed consent. However, individuals with certain conditions, such as previous colorectal cancer or certain hereditary syndromes, are not eligible. If you join the trial, you can expect to be randomly assigned to one of the two follow-up schedules and will be monitored for any signs of returning lesions. The results of this study could help improve future care for patients like you.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients with a single non-pedunculated colorectal lesion (NPCL) ≥20 mm that has been resected piecemeal and treated with thermal ablation (using snare tip or argon plasma) at the margins as prophylaxis against recurrence, and who are awaiting the initiation of specific endoscopic follow-up.
• • Complete colonoscopy with adequate or excellent bowel preparation performed within the last 6 months prior to the resection of the index lesion.
• • Signed informed consent.
• Exclusion Criteria:
• • Resection performed using a cold snare technique due to the high risk of recurrence.
• • Histology of the lesion showing malignancy: colorectal cancer with submucosal invasion, regardless of invasion depth in microns.
• • Absence of information regarding the grade of dysplasia of the index lesion.
• • Personal history of colorectal cancer.
• • Incomplete endoscopic resection of the index lesion or any other polyps present in the patient.
• • When the endoscopist performing the index colonoscopy expresses doubts about whether the resection was complete.
• • Index lesion with prior attempted resection.
• • Hereditary cancer syndromes (e.g., adenomatous or serrated polyposis syndromes, Lynch syndrome, etc.).
• • Inflammatory bowel disease.
• • Severe comorbidities with reduced life expectancy.
• • Pregnancy.
• • Ongoing cytotoxic treatment or radiotherapy for a malignant disease.