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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1502-E1503
DOI: 10.1055/a-1243-0129
Editorial

Considerable practice variation in use of pathological high-risk T1-CRC criteria: Why, and how to do better?

Mathieu Pioche
1   Hépato-gastro-enterologie, Hospices Civils de Lyon, hôpital Edouard Herriot, France
,
Yutaka Saito
2   Endoscopy division, National cancer center hospital, Chuo-Ku, Tokyo, Japan
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Although intramucosal adenocarcinomas are most often not considered T1 colorectal cancers (T1-CRC) in European series [1], they are, nonetheless, cancerous tumors (T1a) owing to invasion into the chorion, and are considered as such by Japanese endoscopists. These lesions have no or negligible risk of lymph node metastasis and most Western endoscopists consider piecemeal endoscopic mucosal resection (EMR) suitable for them, dismissing the need for tumor-free resection margins. However, comparative data to evaluate the risk of missed information induced by piecemeal resection [2], including focal submucosal invasion, are still lacking. This underlines the discordance in the definition of malignant lesions that are present from the very first stage and that also exist at more advanced stages.



Publication History

Article published online:
07 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Refers to:

High practice variation in risk stratification, baseline oncological staging, and follow-up strategies for T1 colorectal cancers in the NetherlandsEndosc Int Open 2020; 08(09): E1117-E1122
DOI: 10.1055/a-1192-3545

 

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