| Theme | <Comprehensible explanation> "JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection" | |
|---|---|---|
| Title | Curability Assessment for colon cancer | |
| Publish Date | 2015/09 | |
| Author | Shoichi Saito | Department of Endoscopy, The Jikei University School of Medicine |
| Author | Masahiro Ikegami | Department of Pathology, The Jikei University School of Medicine |
| [ Summary ] | When pT1 SM cancer is detected in a pathological examination after endoscopic resection, the subsequent therapeutic course should be determined in accordance with the Guidelines 2014 for the Treatment of Colorectal Cancer edited by Japanese Society for Cancer of the Colon and Rectum. Additional surgical operation should be performed for deep stamp-positive lesions due to incomplete endoscopic resection. In the case of complete endoscopic resection, pT1 SM cancer can be judged to have been radically cured when the following items are satisfied in histopathological findings : (1) The vertical stump is negative (complete resection) (2) There is no evidence of papillary adenocarcinoma and tubular adenocarcinoma (tub 1) (3) SM invasion depth is<1000μm (4) Vascular invasion is negative (5) The budding grade is 1. These conditions are comprehensively evaluated, and then it is determined whether follow-up or additional resection is required. When a therapeutic course that satisfies the above five items is selected, the number of cases in which lymph node metastasis and residual/recurrence are found is extremely small (level of evidence：Ⅳb, grade of recommendation : B). |
|