C Martínez Vila1, H Oliveres Montero de Novoa1, E Martínez-Bauer2, X Serra-Aracil3, L Mora3, A Casalots-Casado4, I Macías-Declara1, C Pericay5. 1. Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain. 2. Department of Digestology-Endoscopy, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain. 3. Department of Surgery, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain. 4. Department of Pathology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain. 5. Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain. cpericay@tauli.cat.
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.
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.
Authors: Armin Kuellmer; Julius Mueller; Karel Caca; Patrick Aepli; David Albers; Brigitte Schumacher; Anne Glitsch; Claus Schäfer; Ingo Wallstabe; Christopher Hofmann; Andreas Erhardt; Benjamin Meier; Dominik Bettinger; Robert Thimme; Arthur Schmidt Journal: Gastrointest Endosc Date: 2019-01-14 Impact factor: 9.427
Authors: Eduardo Albéniz; María Pellisé; Antonio Z Gimeno García; Alfredo José Lucendo; Pedro A Alonso Aguirre; Alberto Herreros de Tejada; Marco Antonio Álvarez; María Fraile; Maite Herráiz Bayod; Leopoldo López Rosés; David Martínez Ares; Akiko Ono; Adolfo Parra Blanco; Eduardo Redondo; Andrés Sánchez Yagüe; Santiago Soto; José Díaz Tasende; Marta Montes Díaz; Manuel Rodríguez Téllez; Orlando García; Alba Zuñiga Ripa; Marta Hernández Conde; Fernando Alberca de Las Parras; Carla Gargallo; Esteban Saperas; Miguel Muñoz Navas; Javier Gordillo; Felipe Ramos Zabala; José Manuel Echevarría; Marco Bustamante; Mariano González Haba; Ferrán González Huix; Begoña González Suárez; Juan José Vila Costas; Carlos Guarner Argente; Fernando Múgica; Julyssa Cobián; Joaquín Rodríguez Sánchez; Bartolomé López Viedma; Noel Pin; José Carlos Marín Gabriel; Óscar Nogales; Joaquín de la Peña; Francisco Javier Navajas León; Helena León Brito; David Remedios; José Miguel Esteban; David Barquero; Juan Gabriel Martínez Cara; Felipe Martínez Alcalá; Ignacio Fernández Urién; Eduardo Valdivielso Journal: Gastroenterol Hepatol Date: 2018-02-12 Impact factor: 2.102
Authors: J H Suh; K S Han; B C Kim; C W Hong; D K Sohn; H J Chang; M J Kim; S C Park; J W Park; H S Choi; J H Oh Journal: Endoscopy Date: 2012-05-25 Impact factor: 10.093