| Theme |
Recent topics on colorectal cancer which has been followed clinically |
| Title |
Therapeutic strategies for treatment of colorectal neoplasia, based on natural history-Analysis of follow-up study |
| Author |
Mikihiro Fujiya |
Third Department of Internal Medicine, Asahikawa Medical College |
| Author |
Yusuke Saitoh |
Third Department of Internal Medicine, Asahikawa Medical College |
| Author |
Jiro Watari |
Third Department of Internal Medicine, Asahikawa Medical College |
| Author |
Tomoyuki Ohta |
Gastroenterology Asahikawa Kohsei General Hospital |
| Author |
Yasushi Yamada |
Radiology Asahikawa Kohsei General Hospital |
| Author |
Yutaka Kohgo |
Third Department of Internal Medicine, Asahikawa Medical College |
| [ Summary ] |
We analyzed the clinical course of colorectal neoplasms followed-up with radiography or colonoscopy, in order to elucidate the natural his tory and the therapeutic strategy for colorectal neoplasia. On the basis of the follow-up study, minute mucosal neoplasia (5mm or less in size) had little risk of developing into invasive carcinomas, consequently these are seen not require endoscopic resection. However, endoscopic or surgical treat ments (depending on invasion depth) were seen to be necessary for treatment of larger neoplasias (over 6mm) because of their high potential of tumor growth.
Flat and depressed tumors were considered to be more slow growing than the polypoid type in fol low-up studies. Morphological changes in small colorectal neoplasia were observed by prospective study. Through investigations on cell kinetics, we demonstrated the association of those mor phological changes and the augmentation of apoptosis in colorectal neoplasiac tumor cells. Submucosal invasive carcinomas must be treated as soon as possible because the doubling time of those carcinomas is the same as advanced ones. |