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Long-term outcomes after treatment for T1 colorectal carcinoma: a multicenter retrospective cohort study of Hiroshima GI Endoscopy Research Group

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Abstract

Background

We aimed to clarify the long-term outcomes of patients with T1 colorectal carcinoma (CRC) after endoscopic resection (ER) and surgical resection.

Methods

We examined T1 CRC patients treated during 1992–2008 and who had ≥5 years of follow-up. Patients who did not meet the curative criteria after ER according to the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines were defined as “non-endoscopically curable” and classified into three groups: ER alone (Group A: 121 patients), additional surgery after ER (Group B: 238 patients), and surgical resection alone (Group C: 342 patients). Long-term outcomes and predictors of recurrence were analyzed.

Results

Of the 882 patients with T1 CRC, 701 were non-endoscopically curable. Among these patients, recurrence and 5-year overall survival (OS) rates were 0.6 and 91.1%, respectively. In Groups A, B, and C, recurrence rates were 5.0, 5.5, and 3.8%, OS rates were 79.3, 92.4, and 91.5% (p < 0.01), and 5-year disease-free survival (DFS) rates were 98.1, 97.9, and 98.5%, respectively. Thirty-two patients experienced local recurrence or distant/lymph node metastasis (Group A: 6; Group B: 13; Group C: 13) and 14 patients died of primary CRC (Group A: 3; Group B: 7; Group C: 4). Age ≥65 years, protruded gross type, positive lymphatic invasion, and high budding grade were significant predictors of recurrence in non-endoscopically curable patients.

Conclusions

Our findings supported the JSCCR criteria for endoscopically curable T1 CRC. ER for T1 CRC did not worsen the clinical outcomes of patients who required additional surgical resection.

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Acknowledgements

This study was conducted with a Grant-in-Aid from the Japan Agency for Medical Research and Development, AMED (15ck0106102h0102).

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Authors and Affiliations

  1. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yuzuru Tamaru, Shiro Oka & Kazuaki Chayama

  2. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

    Shiro Oka & Shinji Tanaka

  3. Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

    Shinji Nagata

  4. Department of Endoscopy, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Yuko Hiraga

  5. Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan

    Toshio Kuwai

  6. Department of Gastroenterology, JA Hiroshima General Hospital, Hiroshima, Japan

    Akira Furudoi

  7. Department of Internal Medicine, Hiroshimakinen Hospital, Hiroshima, Japan

    Tadamasa Tamura

  8. Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

    Masaki Kunihiro

  9. Department of Gastroenterology, Chugoku Rosai Hospital, Kure, Japan

    Hideharu Okanobu

  10. Department of Gastroenterology, JA Onomichi General Hospital, Onomichi, Japan

    Koichi Nakadoi

  11. Department of Gastroenterology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Hiroyuki Kanao

  12. Department of Gastroenterology, Shobara Red Cross Hospital, Shobara, Japan

    Makoto Higashiyama

  13. Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan

    Koji Arihiro

  14. Department of Anatomical Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan

    Kazuya Kuraoka

  15. Faculty of Humanities, Hiroshima Shudo University, Hiroshima, Japan

    Fumio Shimamoto

Authors
  1. Yuzuru Tamaru
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  2. Shiro Oka
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  3. Shinji Tanaka
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  4. Shinji Nagata
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  5. Yuko Hiraga
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  15. Kazuya Kuraoka
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  17. Kazuaki Chayama
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Corresponding author

Correspondence to Shiro Oka.

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Tamaru, Y., Oka, S., Tanaka, S. et al. Long-term outcomes after treatment for T1 colorectal carcinoma: a multicenter retrospective cohort study of Hiroshima GI Endoscopy Research Group. J Gastroenterol 52, 1169–1179 (2017). https://doi.org/10.1007/s00535-017-1318-1

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  • DOI: https://doi.org/10.1007/s00535-017-1318-1

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