Journal of Gastroenterology

, Volume 51, Issue 7, pp 702–710 | Cite as

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

  • Naoki Asayama
  • Shiro OkaEmail author
  • Shinji Tanaka
  • Shinji Nagata
  • Akira Furudoi
  • Toshio Kuwai
  • Seiji Onogawa
  • Tadamasa Tamura
  • Hiroyuki Kanao
  • Yuko Hiraga
  • Hideharu Okanobu
  • Takayasu Kuwabara
  • Masaki Kunihiro
  • Shinichi Mukai
  • Eizo Goto
  • Fumio Shimamoto
  • Kazuaki Chayama
Original Article—Alimentary Tract



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.


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.


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).


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.


Pedunculated-type T1 colorectal carcinoma Lymph node metastasis Clinicopathological characteristics Outcomes 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Japanese Society of Gastroenterology 2015

Authors and Affiliations

  • Naoki Asayama
    • 1
  • Shiro Oka
    • 1
    Email author
  • Shinji Tanaka
    • 1
  • Shinji Nagata
    • 2
  • Akira Furudoi
    • 3
  • Toshio Kuwai
    • 4
  • Seiji Onogawa
    • 5
  • Tadamasa Tamura
    • 6
  • Hiroyuki Kanao
    • 7
  • Yuko Hiraga
    • 8
  • Hideharu Okanobu
    • 9
  • Takayasu Kuwabara
    • 10
  • Masaki Kunihiro
    • 11
  • Shinichi Mukai
    • 12
  • Eizo Goto
    • 13
  • Fumio Shimamoto
    • 14
  • Kazuaki Chayama
    • 15
  1. 1.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  2. 2.Department of GastroenterologyHiroshima City Asa Citizens HospitalHiroshimaJapan
  3. 3.Department of GastroenterologyJA Hiroshima General HospitalHiroshimaJapan
  4. 4.Department of GastroenterologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterHiroshimaJapan
  5. 5.Department of GastroenterologyOnomichi General HospitalHiroshimaJapan
  6. 6.Department of Internal MedicineHiroshimakinen HospitalHiroshimaJapan
  7. 7.Department of GastroenterologyHiroshima Red Cross Hospital and Atomic-bomb Survivors HospitalHiroshimaJapan
  8. 8.Department of EndoscopyHiroshima Prefectural HospitalHiroshimaJapan
  9. 9.Department of GastroenterologyChugoku Rosai HospitalHiroshimaJapan
  10. 10.Department of GastroenterologyShobara Red Cross HospitalHiroshimaJapan
  11. 11.Department of Internal MedicineHiroshima City Hiroshima Citizens HospitalHiroshimaJapan
  12. 12.Department of GastroenterologyMiyoshi Central HospitalHiroshimaJapan
  13. 13.Department of GastroenterologyHigashihiroshima Medical CenterHiroshimaJapan
  14. 14.Department of Health Science, Faculty of Human Culture and SciencePrefectural University of HiroshimaHiroshimaJapan
  15. 15.Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan

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