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Journal of Gastroenterology

, Volume 52, Issue 11, pp 1169–1179 | Cite as

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

  • Yuzuru Tamaru
  • Shiro OkaEmail author
  • Shinji Tanaka
  • Shinji Nagata
  • Yuko Hiraga
  • Toshio Kuwai
  • Akira Furudoi
  • Tadamasa Tamura
  • Masaki Kunihiro
  • Hideharu Okanobu
  • Koichi Nakadoi
  • Hiroyuki Kanao
  • Makoto Higashiyama
  • Koji Arihiro
  • Kazuya Kuraoka
  • Fumio Shimamoto
  • Kazuaki Chayama
Original Article—Alimentary Tract

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.

Keywords

T1 colorectal carcinoma Treatment Recurrence Prognosis 

Notes

Acknowledgements

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

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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  • Yuzuru Tamaru
    • 1
  • Shiro Oka
    • 1
    • 2
    Email author
  • Shinji Tanaka
    • 2
  • Shinji Nagata
    • 3
  • Yuko Hiraga
    • 4
  • Toshio Kuwai
    • 5
  • Akira Furudoi
    • 6
  • Tadamasa Tamura
    • 7
  • Masaki Kunihiro
    • 8
  • Hideharu Okanobu
    • 9
  • Koichi Nakadoi
    • 10
  • Hiroyuki Kanao
    • 11
  • Makoto Higashiyama
    • 12
  • Koji Arihiro
    • 13
  • Kazuya Kuraoka
    • 14
  • Fumio Shimamoto
    • 15
  • Kazuaki Chayama
    • 1
  1. 1.Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
  2. 2.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  3. 3.Department of GastroenterologyHiroshima City Asa Citizens HospitalHiroshimaJapan
  4. 4.Department of EndoscopyHiroshima Prefectural HospitalHiroshimaJapan
  5. 5.Department of GastroenterologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterKureJapan
  6. 6.Department of GastroenterologyJA Hiroshima General HospitalHiroshimaJapan
  7. 7.Department of Internal MedicineHiroshimakinen HospitalHiroshimaJapan
  8. 8.Department of Internal MedicineHiroshima City Hiroshima Citizens HospitalHiroshimaJapan
  9. 9.Department of GastroenterologyChugoku Rosai HospitalKureJapan
  10. 10.Department of GastroenterologyJA Onomichi General HospitalOnomichiJapan
  11. 11.Department of GastroenterologyHiroshima Red Cross Hospital & Atomic-bomb Survivors HospitalHiroshimaJapan
  12. 12.Department of GastroenterologyShobara Red Cross HospitalShobaraJapan
  13. 13.Department of Anatomical PathologyHiroshima University HospitalHiroshimaJapan
  14. 14.Department of Anatomical PathologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterKureJapan
  15. 15.Faculty of HumanitiesHiroshima Shudo UniversityHiroshimaJapan

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