ArticleUnited European gastroenterology journal2022
The COlorectal NEoplasia Endoscopic Classification to Choose the Treatment classification for identification of large laterally spreading lesions lacking submucosal carcinomas: A prospective study of 663 lesions.
Article in United European gastroenterology journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 27 citations in OpenAlex.
- Advancements and limitations of image-enhanced endoscopy in colorectal lesion diagnosis and treatment selection: A narrative review.DEN open · 2026Review
- Impact of Teleconsultation before Endoscopic Submucosal Dissection on Quality of Care and Environmental Sustainability: A French Multicenter Study.Endoscopy international open · 2026Article
- Histological prediction and choice of the best resection strategy in front of a colorectal lesion > 2 cm: prospective comparison of endoscopic characterization, non-targeted and targeted biopsies.Surgical endoscopy · 2025Article
- Endoscopic approach to large non-pedunculated colorectal polyps.Journal of the Canadian Association of Gastroenterology · 2025Article
- Effect of gastroenterology resident use of a social network workgroup on skills in characterizing colorectal neoplasia: Prospective study.Endoscopy international open · 2025Article
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- Value of green sign and chicken skin aspects for detecting malignancy of colorectal neoplasia in a prospective characterization study.Endoscopy international open · 2024Article
- A collaborative application for characterizing colorectal lesions could improve quality of tumor resection.Endoscopy · 2023Article
- A diagnostic test: diagnostic value of gastrointestinal endoscopy narrow-band imaging (NBI) for colorectal laterally spreading tumor (LST) and submucosal invasion.Translational cancer research · 2022Article
- UEG week and UEG journal: A strong scientific liaison.United European gastroenterology journal · 2022Article
- The COlorectal NEoplasia Endoscopic Classification to Choose the Treatment classification for identification of large laterally spreading lesions lacking submucosal carcinomas: A prospective study of 663 lesions.United European gastroenterology journal · 2022Article
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13 authors at 4 institutions in 1 country.
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Abstract
introductionOptical diagnosis is necessary when selecting the resection modality for large superficial colorectal lesions. The COlorectal NEoplasia Endoscopic Classification to Choose the Treatment (CONECCT) encompasses overt (irregular pit or vascular pattern) and covert (macroscopic features) signs of carcinoma in an all-in-one classification using validated criteria. The CONECCT IIC subtype corresponds to adenomas with a high risk of superficial carcinoma that should be resected en bloc with free margins.
methodsThis prospective multicentre study investigated the diagnostic accuracy of the CONECCT classification for predicting submucosal invasion in colorectal lesions >20 mm. Optical diagnosis before en bloc resection by endoscopic submucosal dissection (ESD) was compared with the final histological diagnosis. Diagnostic accuracy for the CONECCT IIC subtype was compared with literature-validated features of concern considered to be risk factors for submucosal invasion (non-granular large spreading tumour [NG LST], macronodule >1 cm, SANO IIIA area, and Paris 0-IIC area).
resultsSix hundred 63 lesions removed by ESD were assessed. The en bloc, R0, and curative resection rates were respectively 96%, 85%, and 81%. The CONECCT classification had a sensitivity (Se) of 100%, specificity (Sp) of 26.2%, positive predictive value of 11.6%, and negative predictive value (NPV) of 100% for predicting at least submucosal adenocarcinoma. The sensitivity of CONECCT IIC (100%) to predict submucosal cancer was superior to all other criteria evaluated. COlorectal NEoplasia Endoscopic Classification to Choose the Treatment IIC lesions constituted 11.5% of all submucosal carcinomas.
conclusionThe CONECCT classification, which combines covert and overt signs of carcinoma, identifies with very perfect sensitivity (Se 100%, NPV 100%) the 30% of low-risk adenomas in large laterally spreading lesions treatable by piecemeal endoscopic mucosal resection or ESD according to expertise without undertreatment. However, the low specificity of CONECCT leads to a large number of potentially not indicated ESDs for suspected high-risk lesions.
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