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Long-term outcomes after treatment for pedunculated-type T1 colorectal carcinoma: a multicenter retrospective cohort study

  • Original Article—Alimentary Tract
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Abstract

Background

The risk for lymph node metastasis and the prognostic significance of pedunculated-type T1 colorectal carcinomas (CRCs) require further study. We aimed to assess the validity of the 2014 Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines based on long-term outcomes of pedunculated-type T1 CRCs.

Methods

In this multicenter retrospective cohort study, we examined 176 patients who underwent resection endoscopically or surgically at 14 institutions between January 1990 and December 2010. Patients meeting the JSCCR curative criteria were defined as “endoscopically curable (e-curable)” and those who did not were “non-e-curable”. We evaluated the prognosis of 116 patients (58 e-curable, 58 non-e-curable) who were observed for >5 years after treatment.

Results

Overall incidence of lymph node metastasis was 5 % (4/81; 95 % confidence interval 1.4–12 %: three cases of submucosal invasion depth ≥1000 μm [stalk invasion] and lymphatic invasion, one case of head invasion and budding grade 2/3). There was no local or metastatic recurrence in the e-curable patients, but six of them died of another cause (observation period, 80 months). There was no local recurrence in the non-e-curable patients; however, distant metastasis was observed in one patient. Death due to the primary disease was not observed in non-e-curable patients, but six of them died of another cause (observation period, 72 months).

Conclusions

Our data support the validity of the JSCCR curative criteria for pedunculated-type T1 CRCs. Endoscopic resection cannot be considered curative for pedunculated-type T1 CRC with head invasion alone.

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Author information

Authors and Affiliations

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

    Naoki Asayama, Shiro Oka & Shinji Tanaka

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

    Shinji Nagata

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

    Akira Furudoi

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

    Toshio Kuwai

  5. Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan

    Seiji Onogawa

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

    Tadamasa Tamura

  7. Department of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Hiroyuki Kanao

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

    Yuko Hiraga

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

    Hideharu Okanobu

  10. Department of Gastroenterology, Shobara Red Cross Hospital, Hiroshima, Japan

    Takayasu Kuwabara

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

    Masaki Kunihiro

  12. Department of Gastroenterology, Miyoshi Central Hospital, Hiroshima, Japan

    Shinichi Mukai

  13. Department of Gastroenterology, Higashihiroshima Medical Center, Hiroshima, Japan

    Eizo Goto

  14. Department of Health Science, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan

    Fumio Shimamoto

  15. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan

    Kazuaki Chayama

Authors
  1. Naoki Asayama
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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. Akira Furudoi
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  6. Toshio Kuwai
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  7. Seiji Onogawa
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  8. Tadamasa Tamura
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  9. Hiroyuki Kanao
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  10. Yuko Hiraga
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  11. Hideharu Okanobu
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  12. Takayasu Kuwabara
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  13. Masaki Kunihiro
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  14. Shinichi Mukai
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  15. Eizo Goto
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  16. Fumio Shimamoto
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  17. Kazuaki Chayama
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Corresponding author

Correspondence to Shiro Oka.

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Asayama, N., Oka, S., Tanaka, S. et al. Long-term outcomes after treatment for pedunculated-type T1 colorectal carcinoma: a multicenter retrospective cohort study. J Gastroenterol 51, 702–710 (2016). https://doi.org/10.1007/s00535-015-1144-2

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  • DOI: https://doi.org/10.1007/s00535-015-1144-2

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