دورية أكاديمية
Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma.
| العنوان: | Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma. |
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| المؤلفون: | Bae HJ; Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Ju H; Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea., Lee HH; Department of Internal Medicine, Yeoido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Kim J; Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Lee BI; Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea., Lee SH; Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Won DD; Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Lee YS; Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Lee IK; Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Cho YS; Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. yscho@catholic.ac.kr. |
| المصدر: | Surgical endoscopy [Surg Endosc] 2023 Feb; Vol. 37 (2), pp. 1231-1241. Date of Electronic Publication: 2022 Sep 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1992- : New York : Springer Original Publication: [Berlin] : Springer International, c1987- |
| مواضيع طبية MeSH: | Colorectal Neoplasms*/surgery, Humans ; Retrospective Studies ; Endoscopy ; Prognosis ; Lymphatic Metastasis ; Risk Factors ; Neoplasm Recurrence, Local/pathology |
| مستخلص: | Background: The long-term outcomes of patients with T1 colorectal cancer (CRC) who undergo endoscopic and/or surgical treatment are not well understood. Invasive CRC confined to the colonic submucosa (T1 CRC) is challenging in terms of clinical decision-making. We compared the long-term outcomes of T1 CRC by treatment method. Methods: We examined 370 patients with pathological T1 CRC treated between 2000 and 2015 at Seoul St. Mary's Hospital. In total, 93 patients underwent endoscopic resection (ER) only, 82 underwent additional surgery after ER, and 175 underwent surgical resection only. Patients who did not meet the curative criteria were defined as "high-risk." High-risk patients were classified into three groups according to the treatment modalities: ER only (Group A: 35 patients), additional surgery after ER (Group B: 72 patients), and surgical resection only (Group C: 133 patients). The recurrence-free and overall survival (OS) rates, and factors associated with recurrence and mortality, were analyzed. Factors associated with lymph node metastasis (LNM) were subjected to multivariate analysis. Results: Of the 370 patients, 7 experienced recurrence and 7 died. All recurrences occurred in the high-risk group and two deaths were in the low-risk group. In high-risk groups, there was no significant group difference in recurrence-free survival (P = 0.511) or OS (P =0.657). Poor histology (P =0.042) was associated with recurrence, and vascular invasion (P =0.044) with mortality. LNMs were observed in 30 of 277 patients who underwent surgery either initially or secondarily. Lymphatic invasion was significantly associated with the incidence of LNM (P < 0.001). Conclusions: ER prior to surgery did not affect the prognosis of high-risk T1 CRC patients, and did not worsen the clinical outcomes of patients who required additional surgery. Lymphatic invasion was the most important predictor of LNM. (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Colorectal neoplasms; Lymphatic metastasis; Survival rate; Treatment outcome |
| تواريخ الأحداث: | Date Created: 20220928 Date Completed: 20230224 Latest Revision: 20230510 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1007/s00464-022-09649-1 |
| PMID: | 36171453 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-2218 |
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| DOI: | 10.1007/s00464-022-09649-1 |