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Risk of recurrence after endoscopic resection of nonpedunculated T1 colorectal cancer

Arthursson, Victoria LU orcid ; Medic, Selma LU ; Syk, Ingvar LU ; Rönnow, Carl-Fredrik LU and Thorlacius, Henrik LU (2022) In Endoscopy 54(11). p.1071-1077
Abstract

BACKGROUND: The long-term outcome after local excision of T1 colorectal cancer (CRC) remains unknown. The aim of this study was to examine clinical and histopathological risk factors for recurrence in patients with T1 CRC undergoing endoscopic resection.

METHODS: This was a retrospective registry-based population study on prospectively collected data of all patients with nonpedunculated T1 CRC undergoing only local excision (no salvage surgery) in Sweden between 2009 and 2018. Potential risk factors for recurrence, including age, sex, tumor location, resection margins, lymphovascular, perineural, and submucosal invasion, grade of differentiation, and mucinous subtype, were analyzed using univariate and multivariate cox... (More)

BACKGROUND: The long-term outcome after local excision of T1 colorectal cancer (CRC) remains unknown. The aim of this study was to examine clinical and histopathological risk factors for recurrence in patients with T1 CRC undergoing endoscopic resection.

METHODS: This was a retrospective registry-based population study on prospectively collected data of all patients with nonpedunculated T1 CRC undergoing only local excision (no salvage surgery) in Sweden between 2009 and 2018. Potential risk factors for recurrence, including age, sex, tumor location, resection margins, lymphovascular, perineural, and submucosal invasion, grade of differentiation, and mucinous subtype, were analyzed using univariate and multivariate cox regression.

RESULTS: Median follow-up time was 60 months, and 28 /602 patients (4.7 %) had a recurrence (13 local and 18 distant). Recurrence rate stratified by submucosal invasion was: Sm1 3.5 % (14 /397), Sm2 6.0 % (8 /133), and Sm3 8.3 % (6 /72), with no significant differences. Resection margins, lymphovascular and perineural invasion, grade of differentiation, mucinous subtype, and age were not significant risk factors for recurrence. In contrast, rectal location was found to be a significant risk factor for tumor recurrence in multivariate analysis (hazard ratio 3.08, P = 0.006). The 3- and 5-year disease-free survival was 96.2 % and 91.1 %, respectively, in T1 CRC patients undergoing endoscopic resection.

CONCLUSION: Tumor recurrence was rare (4.7 %) in this large population-based study on recurrence after local excision of nonpedunculated T1 CRC. Rectal location was an independent risk factor for recurrence, suggesting the need for strict surveillance after endoscopic resection of early rectal cancer.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Endoscopy
volume
54
issue
11
pages
1071 - 1077
publisher
Georg Thieme Verlag
external identifiers
  • pmid:35508180
  • scopus:85129849231
ISSN
1438-8812
DOI
10.1055/a-1814-4434
language
English
LU publication?
yes
additional info
Thieme. All rights reserved.
id
f0054cdf-bcf8-4d8f-8a5d-a6685516b33b
date added to LUP
2022-05-06 10:53:35
date last changed
2024-06-13 05:26:08
@article{f0054cdf-bcf8-4d8f-8a5d-a6685516b33b,
  abstract     = {{<p>BACKGROUND: The long-term outcome after local excision of T1 colorectal cancer (CRC) remains unknown. The aim of this study was to examine clinical and histopathological risk factors for recurrence in patients with T1 CRC undergoing endoscopic resection.</p><p>METHODS: This was a retrospective registry-based population study on prospectively collected data of all patients with nonpedunculated T1 CRC undergoing only local excision (no salvage surgery) in Sweden between 2009 and 2018. Potential risk factors for recurrence, including age, sex, tumor location, resection margins, lymphovascular, perineural, and submucosal invasion, grade of differentiation, and mucinous subtype, were analyzed using univariate and multivariate cox regression.</p><p>RESULTS: Median follow-up time was 60 months, and 28 /602 patients (4.7 %) had a recurrence (13 local and 18 distant). Recurrence rate stratified by submucosal invasion was: Sm1 3.5 % (14 /397), Sm2 6.0 % (8 /133), and Sm3 8.3 % (6 /72), with no significant differences. Resection margins, lymphovascular and perineural invasion, grade of differentiation, mucinous subtype, and age were not significant risk factors for recurrence. In contrast, rectal location was found to be a significant risk factor for tumor recurrence in multivariate analysis (hazard ratio 3.08, P = 0.006). The 3- and 5-year disease-free survival was 96.2 % and 91.1 %, respectively, in T1 CRC patients undergoing endoscopic resection.</p><p>CONCLUSION: Tumor recurrence was rare (4.7 %) in this large population-based study on recurrence after local excision of nonpedunculated T1 CRC. Rectal location was an independent risk factor for recurrence, suggesting the need for strict surveillance after endoscopic resection of early rectal cancer.</p>}},
  author       = {{Arthursson, Victoria and Medic, Selma and Syk, Ingvar and Rönnow, Carl-Fredrik and Thorlacius, Henrik}},
  issn         = {{1438-8812}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{11}},
  pages        = {{1071--1077}},
  publisher    = {{Georg Thieme Verlag}},
  series       = {{Endoscopy}},
  title        = {{Risk of recurrence after endoscopic resection of nonpedunculated T1 colorectal cancer}},
  url          = {{http://dx.doi.org/10.1055/a-1814-4434}},
  doi          = {{10.1055/a-1814-4434}},
  volume       = {{54}},
  year         = {{2022}},
}