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- Title
Histological factors contributing to a high risk of recurrence of submucosal invasive cancer (pT1) of the colon and rectum after endoscopic therapy.
- Authors
Ichiro Nakada; Takanobu Tabuchi; Takeshi Nakachi; Jiro Shimazaki; Satoru Konishi; Motonobu Katano; Hideyuki Ubukata; Yoshihisa Goto; Yoshinori Watanabe; Takafumi Tabuchi
- Abstract
Abstract We analyzed the histological high-risk factors for recurrence of submucosal invasive carcinomas (pT1) of the colon and rectum after endoscopic therapy, examining pT1 cancers treated primarily by endoscopic resection within a 23-year period. We compared recurrent and nonrecurrent cancers, evaluating the following “highrisk factors” of the primary lesion: massive invasion, a surgical margin 2 mm, well or moderately differentiated adenocarcinoma (G1, G2), and no evidence of angiolymphatic invasion. We analyzed the records of 37 patients with pT1 cancers, including 15 with high-risk factors who underwent subsequent resection. Local recurrence with or without liver metastases developed in 4 of these 15 patients. The histological type was PD in three (75%) of the four recurrent lesions. All four (100%) lesions showed a desmoplastic response (DR). Only 1 (9%) of the 11 patients without recurrence after subsequent surgery had a lesion with a small component of PD, and only three (27%) lesions showed a mild DR. We concluded that endoscopic therapy is inadequate for pT1 cancers with a histological PD component, and/or a DR in the cancer stroma.
- Subjects
CANCER risk factors; COLON cancer; RECTAL cancer; SURGICAL excision; LIVER metastasis; CANCER patients
- Publication
Surgery Today, 2008, Vol 38, Issue 8, p675
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-007-3701-7