The rate of residual lesions after a noncurative ESD for colorectal cancer was assessed in 135 patients in this retrospective multicenter study. In > sm1 cancers with lymphatic permeation or poor differentiation, surgery is warranted based on the high risk of lymph node metastasis, while en bloc and R0 resections even with deeper submucosal invasion were determined to have a low risk of residual lesions. These findings can be used for decision-making after a noncurative ESD.
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