Long-term outcomes after treatment for T1 colorectal carcinoma: a multicenter retrospective cohort study of Hiroshima GI Endoscopy Research Group
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We aimed to clarify the long-term outcomes of patients with T1 colorectal carcinoma (CRC) after endoscopic resection (ER) and surgical resection.
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.
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.
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.
KeywordsT1 colorectal carcinoma Treatment Recurrence Prognosis
This study was conducted with a Grant-in-Aid from the Japan Agency for Medical Research and Development, AMED (15ck0106102h0102).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest
- 19.Oka S, Tanaka S, Kanao H, et al. Mid-term prognosis after endoscopic resection for submucosal colorectal carcinoma: summary of a multicenter questionnaire survey conducted by the colorectal endoscopic resection standardization implementation working group in Japanese Society for Cancer of the Colon and Rectum. Dig Endosc. 2011;23:190–4.CrossRefPubMedGoogle Scholar
- 25.Belderbos TD, van Erning FN, de Hingh IH, et al. Long-term recurrence-free survival after standard endoscopic resection versus surgical resection of submucosal invasive colorectal cancer: a population-based study. Clin Gastroenterol Hepatol. 2016;. doi: 10.1016/j.cgh.2016.08.041.PubMedGoogle Scholar
- 26.Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. Revision 4th ed. Tokyo: Kanehara & Co., Ltd.; 1986.Google Scholar
- 27.Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. Revision 5th ed. Tokyo: Kanehara & Co., Ltd.; 1994.Google Scholar
- 28.Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. 1998 6th ed. Tokyo: Kanehara & Co., Ltd.; 1998.Google Scholar
- 29.Japanese Society for Cancer of the Colon and Rectum. JSCCR guidelines 2005 for the treatment of colorectal cancer. Tokyo: Kanehara & Co., Ltd; 2005.Google Scholar