| Theme | For Adequate Operation of Colorectal ESD/EMR Guidelines | |
|---|---|---|
| Title | Management for Early Colorectal Cancer after Endoscopic Resection | |
| Publish Date | 2016/01 | |
| Author | Taku Sakamoto | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Endoscopy Division, National Cancer Center Hospital |
| Author | Masayoshi Yamada | Endoscopy Division, National Cancer Center Hospital |
| Author | Takeshi Nakajima | Endoscopy Division, National Cancer Center Hospital |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| [ Summary ] | Evaluating the curability of T1 colorectal cancer after endoscopic resection is challenging. First, growth pattern (polypoid growth or non‒polypoid growth) is known to affect the malignant features of early colorectal cancer. Therefore, the evaluation of curability after endoscopic treatment should not regard the polypoid growth‒type lesions in the same manner as the non‒polypoid‒type lesions. Second, curability is related to the risk of spontaneous lymph node metastasis after surgery. However, some cases of metachronous metastasis occurring after endoscopic resection have been reported. These cases demonstrate the necessity of assessing long‒term outcomes of endoscopic resection. Therefore, it is necessary to collect data on long‒term clinical outcomes using an appropriate surveillance method after the initial treatment. In terms of intramucosal cancer, the Japan Polyp Study showed that the suitable duration of endoscopic surveillance after curative resection is 3 years. In contrast, surveillance after the endoscopic resection for T1 cancers is not fixed, and is usually planned and executed differently at each facility. We should carefully follow up patients diagnosed with T1 colorectal cancers after endoscopic resection to avoid overlooking metachronous metastasis. |
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