Abstract
Recent progress of endoscopy such as endoscopic submucosal dissection (ESD) enabled to resect Tis/T1 colorectal cancer endoscopically en bloc regardless of its size. In this chapter, we assessed the present status and future perspective of management for Tis/T1 colorectal cancer. Recently, according to the accumulation of many cases and detailed evaluation, after complete endoscopic en bloc resection for T1 colorectal cancer, if below all conditions are satisfied in histological examination, it can be considered curative resection: (1) submucosal invasion depth less than 1000 μm, (2) favorable histologic grade, (3) no vessel involvement, and (4) low budding grade. On the other hand, recent studies revealed that even for T1b cancer, if there are no other metastatic risk factors, estimated lymph node metastatic risk is 1.2–0.4%. On the basis of this evidence, endoscopic treatment is gradually becoming more commonly used to achieve total excisional biopsy even for cT1b colorectal carcinoma. At present, there has been evaluated as clinical research regarding the feasibility of endoscopic resection as total excisional biopsy for T1 cancer that have previously been indicated for surgery. In the future, it is expected to be able to apply molecular markers for judgment for curability after endoscopic resection.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
JSCCR (Japanese Society for Cancer of the Colon and Rectum) guidelines for the treatment of colorectal cancer 2016. Tokyo: Kanahara Shuppan; 2016.
Tanaka S, Asayama N, Shigita K, et al. Towards safer and appropriate application of endoscopic submucosal dissection for T1 colorectal carcinoma as total excisional biopsy: future perspective. Dig Endosc. 2015;27:216–22; (Review).
Nakadoi K, Tanaka S, Kanao H, et al. Management of T1 colorectal carcinoma with special reference to criteria for curative endoscopic resection. J Gastroenterol Hepatol. 2011;27:1057–62.
Yoshii S, Nojima M, Nosho K, et al. Factors associated with risk for colorectal cancer recurrence after endoscopic resection of T1 tumors. Clin Gastroenterol Hepatol. 2014;12:292–302.
Yoda Y, Ikematsu H, Matsuda T, et al. A large-scale multicenter study of long-term outcomes after endoscopic resection for submucosal invasive colorectal cancer. Endoscopy. 2013;45:718–24.
Kobayashi H, Mochizuki H, Morita T, et al. Characteristics of recurrence after curative resection for T1 colorectal cancer: Japanese multicenter study. J Gastroenterol. 2011;46:203–11.
Report of survey in 2009. The database committee of the Japanese Society of Gastroenterological Surgery.
Kudo S. Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy. 1993;25:455–61.
Saitoh Y, Obara T, Einami K, et al. Efficacy of high-frequency ultrasound probes for the preoperative staging of invasion depth in flat and depressed colorectal tumors. Gastrointest Endosc. 1996;44:34–9.
Ozawa S, Tanaka S, Hayashi N, et al. Risk factors for vertical incomplete resection in endoscopic submucosal dissection as total excisional biopsy for submucosal invasive colorectal carcinoma. Int J Color Dis. 2013;28:1247–56.
Aoki R, Tanaka S, Haruma K, et al. MUC1 expression as a predictor of the curative endoscopic treatment of submucosal invasive colorectal carcinoma. Dis Colon Rectum. 1998;41:1262–72.
Oh-e H, Tanaka S, Kitadai Y, et al. Angiogenesis at the site of deepest penetration predicts lymph node metastasis of submucosal colorectal cancer. Dis Colon Rectum. 2001;44:1129–36.
Oh-e H, Tanaka S, Kitadai Y, et al. Cathepsin D expression as a possible predictor of lymph node metastasis in submucosal colorectal cancer. Eur J Cancer. 2001;37:180–8.
Tanaka S, Oka S, Tamura T, et al. Molecular pathologic application as a predictor of lymph node metastasis in submucosal colorectal carcinoma: implication of immunohistochemical alteration as the deepest invasive margin. In: Muto T, Mochizuki H, Masaki T, editors. Tumor budding in colorectal cancer: recent progress in colorectal cancer research. Hauppauge, NY: NOVA; 2006. p. 171–80.
Kawachi H, Eishi Y, Ueno H, et al. A three-tier classification system based on the depth of submucosal invasion and budding/sprouting can improve the treatment strategy for T1 colorectal cancer: a retrospective multicenter study. Mod Pathol. 2015;28:872–9.
Ueno H, Hase K, Hashiguchi Y, et al. Novel risk factors for lymph node metastasis in early invasive colorectal cancer: a multi-institution pathology review. J Gastroenterol. 2014;49:1314–23.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Tanaka, S., Oka, S., Chayama, K. (2020). Treatment Strategy After Endoscopic Resection for Colorectal T1(SM) Cancer: Present Status and Future Perspective. In: Tanaka, S., Saitoh, Y. (eds) Endoscopic Management of Colorectal T1(SM) Carcinoma. Springer, Singapore. https://doi.org/10.1007/978-981-13-6649-9_13
Download citation
DOI: https://doi.org/10.1007/978-981-13-6649-9_13
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-6648-2
Online ISBN: 978-981-13-6649-9
eBook Packages: MedicineMedicine (R0)