| Theme |
Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma |
| Title |
The evidences and known techniques to minimize adverse effects of prior endoscopic therapy for better prognosis of T1 colorectal carcinoma |
| Author |
Shinji Yoshii |
Department of Gastroenterology, Sapporo Medical Center, NTT EC |
| Author |
Hiroyuki Okuda |
Department of Medical Oncology, Keiyukai Sapporo Hospital |
| Author |
Takaya Kusumi |
Department of Sergery, Keiyukai Sapporo Hospital |
| Author |
Hiroyuki Tsukagoshi |
Department of Gastroenterology, Keiyukai Sapporo Hospital |
| [ Summary ] |
As the endoscopic removal of T1 colorectal carcinoma is becoming a common procedure, there has been increasing concern about the adverse effects of subsequent surgery by endoscopic treatment. One of the publications reported that the prior endoscopic procedure possibly increased tumor cell proliferation by electrocautery. The other publication reported the discontinuous lymphovenous invasion which cannot be diagnosed by endoscopically resected materials.
On the other hand, several publications proved the safety of prior endoscopic procedures in terms of long-term survival and adverse events during subsequent operative period. For better survival of T1 colorectal carcinoma patients, the precise pathological diagnosis is important because it enables accurate risk assessment of the patient including the judgement regarding subsequent colon removal. Because most of the pathological assessments were judged based on the invasive tumor front, it is extremely important to remove the tumor completely as 'en-bloc'. Precise endoscopic diagnosis and accurate endoscopic treatment as well as close cooperation with pathologists are required for the endoscopists in the era of endoscopic cancer treatment. |