دورية أكاديمية
Management of non-curative endoscopic resection of T1 colon cancer.
العنوان: | Management of non-curative endoscopic resection of T1 colon cancer. |
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المؤلفون: | Bernklev L; Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway. Electronic address: linn.bernklev@medisin.uio.no., Nilsen JA; Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway; Vestre Viken Hospital Trust, Bærum Hospital, Norway., Augestad KM; Department of Gastrointestinal Surgery, Akershus University Hospital, Lørenskog, Norway; Division of Surgery Campus Ahus, University of Oslo, Oslo, Norway., Holme Ø; Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway; Department of Research, Sorlandet Hospital Trust, Kristiansand, Norway., Pilonis ND; Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway; Medical Center of Postgraduate Education, Warsaw, Poland; Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland; Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland. |
المصدر: | Best practice & research. Clinical gastroenterology [Best Pract Res Clin Gastroenterol] 2024 Feb; Vol. 68, pp. 101891. Date of Electronic Publication: 2024 Feb 21. |
نوع المنشور: | Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101120605 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-1916 (Electronic) Linking ISSN: 15216918 NLM ISO Abbreviation: Best Pract Res Clin Gastroenterol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2004- : Amsterdam : Elsevier Original Publication: London : Baillière Tindall, c2001- |
مواضيع طبية MeSH: | Colorectal Neoplasms*/pathology , Colonic Neoplasms*/surgery, Humans ; Endoscopy/methods ; Lymphatic Metastasis ; Risk Factors ; Retrospective Studies |
مستخلص: | Endoscopic resection techniques enable en-bloc resection of T1 colon cancers. A complete removal of T1 colon cancer can be considered curative when histologic examination of the specimens shows none of the high-risk factors for lymph nodes metastases. Criteria predicting lymph nodes metastases include deep submucosal invasion, poor differentiation, lymphovascular invasion, and high-grade tumor budding. In these cases, complete (R0), local endoscopic resection is considered sufficient as negligible risk of lymph nodes metastases does not outweigh morbidity and mortality associated with surgical resection. Challenges arise when endoscopic resection is incomplete (RX/R1) or high-risk histological features are present. The risk of lymph node metastasis in T1 CRC ranges from 1% to 36.4%, depending on histologic risk factors. Presence of any risk factor labels the patient "high risk," warranting oncologic surgery with mesocolic lymphadenectomy. However, even if 70%-80% of T1-CRC patients are classified as high-risk, more than 90% are without lymph node involvement after oncological surgery. Surgical overtreatment in T1 CRC is a challenge, requiring a balance between oncologic safety and minimizing morbidity/mortality. This narrative review explores the landscape of managing non-curative T1 colon cancer, focusing on the choice between advanced endoscopic resection techniques and surgical interventions. We discuss surveillance strategies and shared decision-making, emphasizing the importance of a multidisciplinary approach. Competing Interests: Declaration of competing interest None of the authors reported any conflicts of interest. (Copyright © 2024. Published by Elsevier Ltd.) |
فهرسة مساهمة: | Keywords: Colectomy; Decision making; Endoscopic resection; Multimodal treatment; Shared; T1 colon cancer |
تواريخ الأحداث: | Date Created: 20240324 Date Completed: 20240326 Latest Revision: 20240326 |
رمز التحديث: | 20240326 |
DOI: | 10.1016/j.bpg.2024.101891 |
PMID: | 38522886 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1532-1916 |
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DOI: | 10.1016/j.bpg.2024.101891 |