Endoscopy 2019; 51(04): S11
DOI: 10.1055/s-0039-1681201
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Colon ESD South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

INVASIVE RECURRENCE RATE AND CLINICOPATHOLOGICAL FEATURES AFTER ENDOSCOPIC RESECTION FOR 591 T1 COLORECTAL CANCERS

K Kawashima
1   National Cancer Center Hospital, Tokyo, Japan
,
Y Saito
1   National Cancer Center Hospital, Tokyo, Japan
,
Y Mizuguchi
1   National Cancer Center Hospital, Tokyo, Japan
,
H Takamaru
1   National Cancer Center Hospital, Tokyo, Japan
,
SYS Wu
1   National Cancer Center Hospital, Tokyo, Japan
,
M Sekiguchi
1   National Cancer Center Hospital, Tokyo, Japan
,
M Yamada
1   National Cancer Center Hospital, Tokyo, Japan
,
T Sakamoto
1   National Cancer Center Hospital, Tokyo, Japan
,
T Matsuda
1   National Cancer Center Hospital, Tokyo, Japan
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Publikationsverlauf

Publikationsdatum:
18. März 2019 (online)

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Aims:

Recent studies reported that invasion depth only has no clinical impact to lymph node metastasis (LNM) of colorectal cancer (CRC). Several recurrent cases have been reported, however, after endoscopic resection for T1b (SM deep) CRC without any unfavorable histological factors. We, therefore, aim to investigate the recurrence rate and clinicopathological features associated with invasive recurrence after endoscopic resection for T1 CRC.

Methods:

A total of 516 patients (591 lesions) with T1 CRCs treated by endoscopic resection (ER) between January 2000 and December 2017 at NCCH were analyzed retrospectively. We evaluated the invasive recurrence (distant metastasis and invasive cancer recurrence) rate and clinicopathological features of primary CRC.

Results:

The invasive recurrence rate for overall T1 CRC was 2.9% (17/591), while that of T1b CRC was 4.7% (15/317). Among them, 139 T1b CRC patients showed any other unfavorable histological factors, but five patients (3.6%) showed invasive recurrences. In these139 patients, 87 patients (64%) underwent surgery within 3 months, and 3 of 87 (3.4%) showed invasive recurrences (two lungs, one liver). On the other hand, 52 patients (37%) were followed-up without surgery, and 2 of 52 (3.8%) showed invasive metastasis (one lung with local, and one liver with local). The median period from ER to diagnosis of recurrence was 45 months (range, 6 – 73 months) in surgery group and 30.9 months (range, 0 – 175 months) in non-surgery group. All of five cases were resected by en-bloc ER with VM0. Three were well differentiated adenocarcinoma, 2 were well and moderately differentiated adenocarcinoma, originally. The median depth of invasion was 1250 mm (range, 1000 – 7500 mm). The interruption of muscularis mucosae was seen in four cases and abscess formation in one.

Conclusions:

The invasive recurrences for T1b CRC was 4.7% overall and 3.6% for T1b without any unfavorable histological factors. This recurrence rate was similar in patients with and without surgery.