INTESTINE Vol.12 No.5(1-2-1)

Theme Small invasive cancer of colon and rectum less than 10 mm
Title Clinicopathological characteristics and treatment of cancer with SM invasion in a colorectal tnmor measuring 10 mm or less in size
Publish Date 2008/09
Author Ritsuo Mouri Department of Endoscopy, Hiroshima University Hospital
Author Shiro Oka Department of Endoscopy, Hiroshima University Hospital
Author Shinji Tanaka Department of Endoscopy, Hiroshima University Hospital
Author Hiroyuki Kanao Department of Gastroenterology, Hiroshima University Hospital
Author Mayuko Hirata Department of Gastroenterology, Hiroshima University Hospital
Author Shigeto Yoshida Department of Endoscopy, Hiroshima University Hospital
Author Kazuaki Chayama Department of Gastroenterology, Hiroshima University Hospital
[ Summary ] The clinicopathological characteristics of small colorectal tumors measuring 10 mm or less in size were studied. Treatment of colorectal cancer with SM invasion was specifically considered. Lesions with depressions tend to be highly malignant even if they are small. Therefore, it is important to perform endoscopic observations while carefully searching for the presence of depressions in small colorectal tumors. If there is any possibility of such depressions, then either additional chromoendoscopy or magnifying endoscopy is required.
The rate of lymph node metastasis in small colorectal cancers (10 mm or less in size) with SM invasion was investigated during surgical resections. There was no metastasis in lesions 5 mm or less in size. In lesions measuring 6 mm to 10 mm in size, the rate of lymph node metastasis was 5.3 % overall, while it was 11 % in lesions with depressions.
In lesions measuring 5 mm or less in size, endoscopic treatment with total biopsies should be carried out for lesions with any possibility of SM invasion. Furthermore, treatment should be determined based on the histopathological findings. Lesions measuring from 6 mm to 10 mm should be treated in the same way as lesions larger than 10 mm.
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