Naoki Asayama1, Shiro Oka2, Shinji Tanaka3, Yuki Ninomiya1, Yuzuru Tamaru1, Kenjiro Shigita1, Nana Hayashi1, Hiroyuki Egi4, Takao Hinoi4, Hideki Ohdan4, Koji Arihiro5, Kazuaki Chayama1. 1. Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. 2. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan. oka4683@hiroshima-u.ac.jp. 3. Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan. 4. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. 5. Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan.
Abstract
PURPOSE: Long-term outcomes of patients with T1 colorectal carcinoma (CRC) treated by endoscopic resection (ER) or surgical resection are unclear in relation to the curative criteria in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines. The aim of this study was to retrospectively compare the long-term outcomes among patients with T1 CRC in relation to the treatment methods. METHODS: We examined 322 T1 CRC cases treated between January 1992 and August 2008 at Hiroshima University Hospital. Patients who did not meet the curative criteria in the JSCCR guidelines were defined as "non-endoscopically curable" and classified into three groups: underwent ER alone (group A: 45 patients), underwent additional surgery after ER (group B: 106 patients), and underwent surgical resection alone (group C: 92 patients). RESULTS: Of the 322 T1 CRC patients, 79 were categorized as endoscopically curable and 243 as non-endoscopically curable. Among the endoscopically curable T1 CRC patients, recurrence and 5-year OS rates were 0 and 94.2%, respectively. In groups A, B, and C, recurrence rates were 4.4, 6.6, and 4.3%, and OS rates were 85.6, 95.1, and 96.3%, respectively (p < 0.05). Local recurrence or distant/lymph node metastasis was observed in 13 patients (group A: 2; group B: 7; group C: 4). Death due to primary CRC occurred in six patients (group B: 4; group C: 2). CONCLUSION: Long-term outcomes support the curative criteria according to the JSCCR guidelines. ER for T1 CRC did not worsen clinical outcomes in cases that required additional surgical resection.
PURPOSE: Long-term outcomes of patients with T1 colorectal carcinoma (CRC) treated by endoscopic resection (ER) or surgical resection are unclear in relation to the curative criteria in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines. The aim of this study was to retrospectively compare the long-term outcomes among patients with T1 CRC in relation to the treatment methods. METHODS: We examined 322 T1 CRC cases treated between January 1992 and August 2008 at Hiroshima University Hospital. Patients who did not meet the curative criteria in the JSCCR guidelines were defined as "non-endoscopically curable" and classified into three groups: underwent ER alone (group A: 45 patients), underwent additional surgery after ER (group B: 106 patients), and underwent surgical resection alone (group C: 92 patients). RESULTS: Of the 322 T1 CRC patients, 79 were categorized as endoscopically curable and 243 as non-endoscopically curable. Among the endoscopically curable T1 CRC patients, recurrence and 5-year OS rates were 0 and 94.2%, respectively. In groups A, B, and C, recurrence rates were 4.4, 6.6, and 4.3%, and OS rates were 85.6, 95.1, and 96.3%, respectively (p < 0.05). Local recurrence or distant/lymph node metastasis was observed in 13 patients (group A: 2; group B: 7; group C: 4). Death due to primary CRC occurred in six patients (group B: 4; group C: 2). CONCLUSION: Long-term outcomes support the curative criteria according to the JSCCR guidelines. ER for T1 CRC did not worsen clinical outcomes in cases that required additional surgical resection.
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