| Theme | Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma | |
|---|---|---|
| Title | Indication criteria for endoscopic resection of early colorectal carcinoma according to JSCCR Guidelines 2019 for the treatment of colorectal cancer and stratification of the risk of lymph node metastasis of T1 colorectal carcinoma | |
| Publish Date | 2019/06 | |
| Author | Yoichi Ajioka | Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University |
| [ Summary ] | According to Japanese Society for Cancer of the Colon and Rectum Guidelines 2019 for the treatment of colorectal cancer, treatment strategies for early colorectal carcinoma are recommended based on the risk of lymph node metastasis of the tumor. Indication criteria for endoscopic resection of early colorectal carcinoma are cTis or cT1 with slight submucosal invasion, and en bloc resection is possible. For pT1 colorectal carcinoma after endoscopic resection, the curative criteria (recommendation of surveillance without additional surgical resection) are vertical margin negativity; papillary, tubular, or medullary carcinoma; pT1a; vascular invasion negativity； and BD1 budding. Based on the results of stratification of the risk of lymph node metastasis of T1 colorectal carcinoma, it is suggested that patients with pT1b without any of the risk factors for lymph node metastasis can be expected to be treated by endoscopic resection alone, and this may lead to the expansion of the criteria for endoscopic resection of early colorectal carcinoma. | |