Widely accepted predictors of local recurrence after endoscopic resection of T1 cancers include rectal location, positive resection margin, poor differentiation (PD), lymphovascular invasion (LVI), high-grade tumor budding, and deep submucosal invasion (SMI; >1 mm submucosal invasion depth). Recent studies have suggested that deep SMI, when not accompanied by other histologic risk factors, is likely not an independent risk for residual disease after endoscopic resection.<\/p>\n\n\n\n
A large registry-based study from Sweden included 602 patients who had undergone endoscopic resection of a T1 colorectal cancer (CRC) and lacked synchronous CRC and neoadjuvant therapy. All lesions were nonpedunculated. All included patients had available information on SMI depth as well as follow-up for at least 1 year, with median follow-up 5 years. Overall, 65% of lesions were in the colon, 66% were Sm1 (a surrogate for superficial SMI), and 97% were well or moderately differentiated. In addition, only 3.4% had poor differentiation, 7.7% LVI, 1% perineural invasion, and 3.8% mucinous subtype. R0 resection was achieved in 77.4% of patients, though whether lesions were removed by endoscopic mucosal resection or endoscopic submucosal dissection was not available.<\/p>\n\n\n\n
The total recurrence rate was 4.7%, and recurrence rates in patients with invasion depths of Sm1, Sm2, and Sm3 were 3.5%, 6.0%, and 8.3%, respectively. Multivariate analysis showed no impact on recurrence from invasion depth, LVI, tumor differentiation, or R0 resection. The only independent predictor of recurrence was rectal location, with an overall recurrence rate of 8.0% in rectal cases and 2.8% in colonic cases. Using the traditional risk factors outlined in the European Society of Gastrointestinal Endoscopy guidelines, recurrence occurred in 9% of high-risk patients and 2% of low-risk patients.<\/p>\n","protected":false},"excerpt":{"rendered":"
Widely accepted predictors of local recurrence after endoscopic resection of T1 cancers include rectal location, positive resection margin, poor differentiation (PD), lymphovascular invasion (LVI), high-grade tumor budding, and deep submucosal invasion (SMI; >1 mm submucosal invasion depth). Recent studies have suggested that deep SMI, when not accompanied by other histologic risk factors, is likely not … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1769],"tags":[2058,3290,3099,3098,3277,3276,3293,3291,1948],"class_list":["post-12240","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-asge-kolon","tag-colon-2","tag-high-grade-tumor-budding","tag-lvi","tag-lymphovascular-invasion","tag-pd","tag-poor-differentiation","tag-smi","tag-submucosal-invasion","tag-t1-cancer"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/12240","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=12240"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=12240"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=12240"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}