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A real world analysis of recurrence risk factors for early colorectal cancer T1 treated with standard endoscopic resection

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Abstract

Background and study aim

Currently, endoscopic resection of early colorectal cancer defined as carcinoma with limited invasion of the mucosa (Tis) and submucosa (T1) is possible. However, lymph node spreading increases to 16.2% of cases when tumor invades the submucosa. We analyzed the previously identified factors for lymph node dissemination and recurrence, in our population.

Patients and methods

We analyzed retrospectively all patients with T1 tumors, treated at our center with endoscopic resection and some with additional surgery between January 2006 and January 2018. Statistical analysis was performed using IBM SPSS Statistics 25.0.

Results

One hundred fifty-nine patients were treated with endoscopic resection, 56.6% with additional surgery. The mean age was 68.74 years and 69. 9% were male. All patients who underwent additional surgery presented negative margins and 8.8% presented positive lymph nodes. In a mean follow-up of 23.36 months, 13 patients had relapsed. The risk of relapse did not differ between patients treated with additional surgery from those who only underwent endoscopic resection (p = 0.506).

On the other hand, lymph node dissemination (p = 0.007) and a positive endoscopic margin (p = 0.01) were independent risk factors for relapse. There was a positive association between lymph node dissemination and lymphatic (p = 0.07), vascular (p = 0.007), and perineural (p = 0.001) invasion and also with degree of histological differentiation (p = 0.001).

Conclusion

In our study, lymphatic, vascular, and perineural invasion and also the degree of histological differentiation were associated with lymph node dissemination. However, the only independent risk factors for long-term recurrence were a positive margin and lymph node dissemination.

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Authors and Affiliations

  1. Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain

    C. Martínez Vila, H. Oliveres Montero de Novoa, I. Macías-Declara & C. Pericay

  2. Department of Digestology-Endoscopy, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain

    E. Martínez-Bauer

  3. Department of Surgery, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain

    X. Serra-Aracil & L. Mora

  4. Department of Pathology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain

    A. Casalots-Casado

Authors
  1. C. Martínez Vila
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  2. H. Oliveres Montero de Novoa
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  3. E. Martínez-Bauer
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  4. X. Serra-Aracil
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  5. L. Mora
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  6. A. Casalots-Casado
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  7. I. Macías-Declara
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  8. C. Pericay
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Correspondence to C. Pericay.

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Martínez Vila, C., Oliveres Montero de Novoa, H., Martínez-Bauer, E. et al. A real world analysis of recurrence risk factors for early colorectal cancer T1 treated with standard endoscopic resection. Int J Colorectal Dis 35, 921–927 (2020). https://doi.org/10.1007/s00384-020-03553-7

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  • DOI: https://doi.org/10.1007/s00384-020-03553-7

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