INTESTINE Vol.8 No.2(2-1)

Theme The surveillance program after treatment of colorectal cancers
Title Surveillance after surgical resection of submucosal colorectal cancer
Publish Date 2004/03
Author Shungo Endo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Jun-ichi Tanaka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Hiroshi Kashida Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Fumio Ishida Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kazuo Ohtsuka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Tsukasa Takeuchi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Eiji Hidaka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yoshio Deguchi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yuji Yamaguchi Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Koichi Nagata Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Kishiko Tatsukawa Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Patients with submucosal invasive (sm) colorectal cancer have better prognosis than those with sm cancer in other parts of the gastrointestinal tract. According to the Multi-institutional Registry of Large Bowel Cancer in Japan, the cumulative 5-year survival rate for patients with sm colorectal cancer is 89.6% in the colon and 93.6% in the rectum. Recently, endoscopic mucosal resection techniques have been established for removing early colorectal cancers, however lymph node metastasis occurs in approximately 10% of cases with sm colorectal cancer and distant metastasis is present in about 2%. The ranges of sm colorectal cancer vary from lesions curable with endoscopic resection alone to lesions beyond surgical treatment. The aims of surveillance after the surgical operations for sm colorectal cancer are monitoring of distant metastasis, metachronous multiple cancers, and synchronous multiple cancers, which might have been overlooked during the first examination. Among these factors, metachronous multiple cancer is the most frequently reported. Laterally spreading tumors and depressed lesions especially, can be easily overlooked and therefore should be carefully searched for.
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