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Factors associated with risk for colorectal cancer recurrence after resection

The most recent issue of the Clinical Gastroenterology & Hepatology identifies factors associated with risk for colorectal cancer recurrence after endoscopic resection of T1 tumors.

News image

More information is needed on the long-term outcomes of patients who undergo endoscopic resection of colorectal tumors.

Dr Shinji Yoshii and colleagues from Japan evaluated recurrence of colorectal cancer after endoscopic resection or a combination of endoscopic research and surgery for T1 colorectal tumors.

The research team conducted a retrospective study of 389 patients with T1  colorectal cancer  treated by endoscopic resection from 1989 to 2008 in Sapporo, Japan.

The researchers compared outcomes between patients who underwent subsequent surgery and those who did not, and statistically adjusted baseline differences between the groups according to the propensity scores.

The cumulative risks of recurrence was 20% in the ER only group
Clinical Gastroenterology & Hepatology

The researchers observed almost no risk of cancer recurrence among patients without indications for surgery recommended by the Japanese Society for Cancer of the Colon and Rectum.

The team found that among patients with indications for surgery, the cumulative risks of recurrence were 4% in the ER + SURG group, and 20% in the ER only group.

However, the patients with only deep submucosal invasion had a low cumulative risks of recurrence, even without surgery.

In contrast, the team noted that patients with indications for surgery other than deep submucosal invasion had much better outcomes when they also underwent surgery.

Dr Yoshii's team commented, "On the basis of a retrospective study of patients who underwent endoscopic resection for T1  colorectal cancer, those with tumors with only submucosal invasion are at low risk for cancer recurrence."

"However, patients with other high-risk tumor features have greater risks for cancer recurrence and benefit from subsequent surgery."

Clin Gastroenterol Hepatol 2014: 12(2): 292-302.e3
04 February 2014

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