Skip to main content

Early Colorectal Cancer

  • Chapter
  • First Online:
Practice and Principles in Therapeutic Colonoscopy

Abstract

Recently, the incidence of early colorectal cancer is increasing, and endoscopic resection is accepted as a standard therapy in selectd T1 colorectal cancers. In this chapter, diagnosis, treatment, surveillane and prognosis of T1 colorectal cancer are introduced.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 149.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Murakami T. Pathomorphological diagnosis. Definition and gross classification of early gastric cancer. Gann Monogr Cancer Res. 1971;11:53–5.

    Google Scholar 

  2. Muto T. Early colorectal cancer–concepts and clinical implications: introduction. World J Surg. 2000;24(9):1015.

    Article  CAS  PubMed  Google Scholar 

  3. Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47(2):251–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Dixon MF. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut. 2002;51(1):130–1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Weston AP, Campbell DR. Diminutive colonic polyps: histopathology, spatial distribution, concomitant significant lesions, and treatment complications. Am J Gastroenterol. 1995;90(1):24–8.

    CAS  PubMed  Google Scholar 

  6. Lescher TC, Dockerty MB, Jackman RJ, Beahrs OH. Histopathology of the larger colonic polyp. Dis Colon Rectum. 1967;10(2):118–24.

    Article  CAS  PubMed  Google Scholar 

  7. Kudo S, Lambert R, Allen JI, Fujii H, Fujii T, Kashida H, et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc. 2008;68(4 Suppl):S3–47.

    Article  PubMed  Google Scholar 

  8. Wada Y, Kashida H, Kudo SE, Misawa M, Ikehara N, Hamatani S. Diagnostic accuracy of pit pattern and vascular pattern analyses in colorectal lesions. Dig Endosc. 2010;22(3):192–9.

    Article  PubMed  Google Scholar 

  9. Tanaka S, Sano Y. Aim to unify the narrow band imaging (NBI) magnifying classification for colorectal tumors: current status in Japan from a summary of the consensus symposium in the 79th Annual Meeting of the Japan Gastroenterological Endoscopy Society. Dig Endosc. 2011;23(Suppl 1):131–9.

    Article  PubMed  Google Scholar 

  10. Aiko T, Sasako M. The new Japanese Classification of Gastric Carcinoma: points to be revised. Gastric Cancer. 1998;1(1):25–30.

    Article  PubMed  Google Scholar 

  11. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma - 2nd English edition. Gastric Cancer. 1998;1(1):10–24.

    Article  CAS  PubMed  Google Scholar 

  12. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003;58(6 Suppl):S3–43.

    Google Scholar 

  13. Harada N, Hamada S, Kubo H, Oda S, Chijiiwa Y, Kabemura T, et al. Preoperative evaluation of submucosal invasive colorectal cancer using a 15-MHz ultrasound miniprobe. Endoscopy. 2001;33(3):237–40.

    Article  CAS  PubMed  Google Scholar 

  14. Hurlstone DP, Brown S, Cross SS, Shorthouse AJ, Sanders DS. Endoscopic ultrasound miniprobe staging of colorectal cancer: can management be modified? Endoscopy. 2005;37(8):710–4.

    Article  CAS  PubMed  Google Scholar 

  15. Fu KI, Sano Y, Kato S, Fujii T, Nagashima F, Yoshino T, et al. Chromoendoscopy using indigo carmine dye spraying with magnifying observation is the most reliable method for differential diagnosis between non-neoplastic and neoplastic colorectal lesions: a prospective study. Endoscopy. 2004;36(12):1089–93.

    Article  PubMed  Google Scholar 

  16. Uno Y, Munakata A. The non-lifting sign of invasive colon cancer. Gastrointest Endosc. 1994;40(4):485–9.

    Article  CAS  PubMed  Google Scholar 

  17. Han KS, Sohn DK, Choi DH, Hong CW, Chang HJ, Lim SB, et al. Prolongation of the period between biopsy and EMR can influence the nonlifting sign in endoscopically resectable colorectal cancers. Gastrointest Endosc. 2008;67(1):97–102.

    Article  PubMed  Google Scholar 

  18. Ishiguro A, Uno Y, Ishiguro Y, Munakata A, Morita T. Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer. Gastrointest Endosc. 1999;50(3):329–33.

    Article  CAS  PubMed  Google Scholar 

  19. Kato H, Haga S, Endo S, Hashimoto M, Katsube T, Oi I, et al. Lifting of lesions during endoscopic mucosal resection (EMR) of early colorectal cancer: implications for the assessment of resectability. Endoscopy. 2001;33(7):568–73.

    Article  CAS  PubMed  Google Scholar 

  20. Deyhle P, Largiader F, Jenny S. A method for endoscopic electroresection of sessile colonic polyps. Endoscopy. 1973;5:38–40.

    Article  Google Scholar 

  21. Tanaka S, Oka S, Chayama K. Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection. J Gastroenterol. 2008;43(9):641–51.

    Article  PubMed  Google Scholar 

  22. Lee EJ, Lee JB, Lee SH, Kim DS, Lee DH, Lee DS, et al. Endoscopic submucosal dissection for colorectal tumors–1,000 colorectal ESD cases: one specialized institute’s experiences. Surg Endosc. 2013;27(1):31–9.

    Article  PubMed  Google Scholar 

  23. Elarini T, Wexner SD, Isenberg GA. The need for standardization of colonoscopic tattooing of colonic lesions. Dis Colon Rectum. 2015;58(2):264–7.

    Article  PubMed  Google Scholar 

  24. Hwang MR, Sohn DK, Park JW, Kim BC, Hong CW, Han KS, et al. Small-dose India ink tattooing for preoperative localization of colorectal tumor. J Laparoendosc Adv Surg Tech A. 2010;20(9):731–4.

    Article  PubMed  Google Scholar 

  25. Park JW, Sohn DK, Hong CW, Han KS, Choi DH, Chang HJ, et al. The usefulness of preoperative colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink for localization in laparoscopic colorectal surgery. Surg Endosc. 2008;22(2):501–5.

    Article  CAS  PubMed  Google Scholar 

  26. Volk EE, Goldblum JR, Petras RE, Carey WD, Fazio VW. Management and outcome of patients with invasive carcinoma arising in colorectal polyps. Gastroenterology. 1995;109(6):1801–7.

    Article  CAS  PubMed  Google Scholar 

  27. Cooper HS, Deppisch LM, Gourley WK, Kahn EI, Lev R, Manley PN, et al. Endoscopically removed malignant colorectal polyps: clinicopathologic correlations. Gastroenterology. 1995;108(6):1657–65.

    Article  CAS  PubMed  Google Scholar 

  28. Ueno H, Mochizuki H, Hashiguchi Y, Shimazaki H, Aida S, Hase K, et al. Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology. 2004;127(2):385–94.

    Article  PubMed  Google Scholar 

  29. Seitz U, Bohnacker S, Seewald S, Thonke F, Brand B, Braiutigam T, et al. Is endoscopic polypectomy an adequate therapy for malignant colorectal adenomas? Presentation of 114 patients and review of the literature. Dis Colon Rectum. 2004;47(11):1789–96, discussion 96–7.

    Article  CAS  PubMed  Google Scholar 

  30. Morson BC, Whiteway JE, Jones EA, Macrae FA, Williams CB. Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. Gut. 1984;25(5):437–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Kyzer S, Begin LR, Gordon PH, Mitmaker B. The care of patients with colorectal polyps that contain invasive adenocarcinoma. Endoscopic polypectomy or colectomy? Cancer. 1992;70(8):2044–50.

    Article  CAS  PubMed  Google Scholar 

  32. Tominaga K, Nakanishi Y, Nimura S, Yoshimura K, Sakai Y, Shimoda T. Predictive histopathologic factors for lymph node metastasis in patients with nonpedunculated submucosal invasive colorectal carcinoma. Dis Colon Rectum. 2005;48(1):92–100.

    Article  PubMed  Google Scholar 

  33. Kikuchi R, Takano M, Takagi K, Fujimoto N, Nozaki R, Fujiyoshi T, et al. Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38(12):1286–95.

    Article  CAS  PubMed  Google Scholar 

  34. Sohn DK, Chang HJ, Park JW, Choi DH, Han KS, Hong CW, et al. Histopathological risk factors for lymph node metastasis in submucosal invasive colorectal carcinoma of pedunculated or semipedunculated type. J Clin Pathol. 2007;60(8):912–5.

    Article  PubMed  Google Scholar 

  35. Okabe S, Shia J, Nash G, Wong WD, Guillem JG, Weiser MR, et al. Lymph node metastasis in T1 adenocarcinoma of the colon and rectum. J Gastrointest Surg. 2004;8(8):1032–9, discussion 1039–40.

    Article  PubMed  Google Scholar 

  36. Suh JH, Han KS, Kim BC, Hong CW, Sohn DK, Chang HJ, et al. Predictors for lymph node metastasis in T1 colorectal cancer. Endoscopy. 2012;44(6):590–5.

    Article  CAS  PubMed  Google Scholar 

  37. Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology. 1985;89(2):328–36.

    Article  CAS  PubMed  Google Scholar 

  38. Kudo S. Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy. 1993;25(7):455–61.

    Article  CAS  PubMed  Google Scholar 

  39. Kitajima K, Fujimori T, Fujii S, Takeda J, Ohkura Y, Kawamata H, et al. Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol. 2004;39(6):534–43.

    Article  PubMed  Google Scholar 

  40. Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2012;17(1):1–29.

    Article  PubMed  Google Scholar 

  41. Shieh YS, Lee HS, Shiah SG, Chu YW, Wu CW, Chang LC. Role of angiogenic and non-angiogenic mechanisms in oral squamous cell carcinoma: correlation with histologic differentiation and tumor progression. J Oral Pathol Med. 2004;33(10):601–6.

    Article  PubMed  Google Scholar 

  42. Agarwal D, Pardhe N, Bajpai M, Gupta S, Mathur N, Vanaki SS, et al. Characterization, localization and patterning of lymphatics and blood vessels in oral squamous cell carcinoma: a comparative study using D2-40 and CD-34 IHC marker. J Clin Diagn Res. 2014;8(10):ZC86–9.

    PubMed  PubMed Central  Google Scholar 

  43. WHO. Histological typing of intestinal tumours. In: Jass JR, Sobin LH, editors. World Health Organisation international histological classification of tumours. Berlin: Springer; 1989.

    Google Scholar 

  44. Masaki T, Matsuoka H, Sugiyama M, Abe N, Sakamoto A, Atomi Y. Actual number of tumor budding as a new tool for the individualization of treatment of T1 colorectal carcinomas. J Gastroenterol Hepatol. 2006;21(7):1115–21.

    Article  PubMed  Google Scholar 

  45. Prall F. Tumour budding in colorectal carcinoma. Histopathology. 2007;50(1):151–62.

    Article  CAS  PubMed  Google Scholar 

  46. Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, et al. Genetic alterations during colorectal-tumor development. N Engl J Med. 1988;319(9):525–32.

    Article  CAS  PubMed  Google Scholar 

  47. Kuramoto S, Oohara T. Minute cancers arising de novo in the human large intestine. Cancer. 1988;61(4):829–34.

    Article  CAS  PubMed  Google Scholar 

  48. Shimoda T, Ikegami M, Fujisaki J, Matsui T, Aizawa S, Ishikawa E. Early colorectal carcinoma with special reference to its development de novo. Cancer. 1989;64(5):1138–46.

    Article  CAS  PubMed  Google Scholar 

  49. Goto H, Oda Y, Murakami Y, Tanaka T, Hasuda K, Goto S, et al. Proportion of de novo cancers among colorectal cancers in Japan. Gastroenterology. 2006;131(1):40–6.

    Article  PubMed  Google Scholar 

  50. Umetani N, Sasaki S, Masaki T, Watanabe T, Matsuda K, Muto T. Involvement of APC and K-ras mutation in non-polypoid colorectal tumorigenesis. Br J Cancer. 2000;82(1):9–15.

    Article  CAS  PubMed  Google Scholar 

  51. Yashiro M, Carethers JM, Laghi L, Saito K, Slezak P, Jaramillo E, et al. Genetic pathways in the evolution of morphologically distinct colorectal neoplasms. Cancer Res. 2001;61(6):2676–83.

    CAS  PubMed  Google Scholar 

  52. Han KS, Lim SW, Sohn DK, Chang HJ, Oh JH, Lee JH, et al. Clinicopathological characteristics of T1 colorectal cancer without background adenoma. Color Dis. 2013;15(3):e124–9.

    Article  CAS  Google Scholar 

  53. Davila RE, Rajan E, Baron TH, Adler DG, Egan JV, Faigel DO, et al. ASGE guideline: colorectal cancer screening and surveillance. Gastrointest Endosc. 2006;63(4):546–57.

    Article  PubMed  Google Scholar 

  54. Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143(3):844–57.

    Article  PubMed  Google Scholar 

  55. Steele RJ, Pox C, Kuipers EJ, Minoli G, Lambert R, International Agency for Research on Cancer. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition–management of lesions detected in colorectal cancer screening. Endoscopy. 2012;44(Suppl 3):SE140–50.

    PubMed  Google Scholar 

  56. Benson AB III, Venook AP, Bekaii-Saab T, Chan E, Chen YJ, Cooper HS, et al. Colon cancer, version 3.2014. J Natl Compr Canc Netw. 2014;12(7):1028–59.

    Article  CAS  PubMed  Google Scholar 

  57. Ikematsu H, Yoda Y, Matsuda T, Yamaguchi Y, Hotta K, Kobayashi N, et al. Long-term outcomes after resection for submucosal invasive colorectal cancers. Gastroenterology. 2013;144(3):551–9, quiz e14.

    Article  PubMed  Google Scholar 

  58. Yoshii S, Nojima M, Nosho K, Omori S, Kusumi T, Okuda H, et al. Factors associated with risk for colorectal cancer recurrence after endoscopic resection of T1 tumors. Clin Gastroenterol Hepatol. 2014;12(2):292–302.e3.

    Article  PubMed  Google Scholar 

  59. Nam MJ, Han KS, Kim BC, Hong CW, Sohn DK, Chang HJ, et al. Long-term outcomes of locally or radically resected T1 colorectal cancer. Color Dis. 2016;18(9):852–60.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kyung Su Han M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Han, K.S. (2018). Early Colorectal Cancer. In: Sohn, D. (eds) Practice and Principles in Therapeutic Colonoscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46552-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-46552-3_4

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46551-6

  • Online ISBN: 978-3-662-46552-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics