| Theme |
Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma |
| Title |
Implications and limitations of additional radical surgery for T1 colorectal cancer |
| Author |
Yoshiki Kajiwara |
Department of Surgery, National Defense Medical College |
| Author |
Eiji Shinto |
Department of Surgery, National Defense Medical College |
| Author |
Koichi Okamoto |
Department of Surgery, National Defense Medical College |
| Author |
Hideki Ueno |
Department of Surgery, National Defense Medical College |
| [ Summary ] |
The principle for treatment of pT1 cancers, which are invasive malignant tumors, is intestinal resection with lymph node dissection. Radical surgery can contribute to the prevention of the recurrence of colorectal cancer by removal of lymph node metastasis and extramural discontinuous cancer spread, which are not able to be removed by local resection. However, it is impossible to eliminate the risk of recurrence due to the possibility of existence of distant metastasis. Moreover, although it is rare, radical surgery has the risk of death associated with the operation and might cause postoperative sequelae such as bowel dysfunction, especially in rectal cancer. It is important to determine whether additional treatment for locally resected T1 cancers is indicated after sufficiently considering other factors such as the physical and social background of the individual and the patient's wishes in addition to the accurate assessment of the lymph node metastasis. |