Long-term outcomes after treatment for T1 colorectal carcinoma
Long-term outcomes after treatment for T1 colorectal carcinoma
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DOI：
10.1007/s00384-015-2473-6
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发表时间：
2016-03-01
影响因子：
2.8
通讯作者：
Chayama, Kazuaki
中科院分区：
文献类型：
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作者：
Asayama, Naoki;Oka, Shiro;Chayama, Kazuaki
目的T1期结直肠癌（CRC）患者行内镜切除术（ER）或手术切除术的长期预后与日本结肠直肠癌学会（JSCCR）指南中的治愈标准的关系尚不清楚。本研究的目的是回顾性比较T1期结直肠癌患者的长期预后与治疗methods.Methods，我们检查了322 T1期结直肠癌病例治疗1992年1月至2008年8月在广岛大学医院。不符合JSCCR指南中治愈标准的患者被定义为“内镜下不可治愈”，并分为三组：（A组：45例患者），在ER后接受额外手术（组B：106例患者），仅行手术切除结果322例T1期结直肠癌患者中，79例内镜下可治愈，243例内镜下不可治愈。在内镜下可治愈的T1结直肠癌患者中，复发率和5年OS率分别为0和94.2%。在A、B和C组中，复发率分别为4.4%、6.6%和4.3%，OS率分别为85.6%、95.1%和96.3%（p < 0.05）。13例患者（A组：2例; B组：7例; C组：4例）观察到局部复发或远处/淋巴结转移。6例（B组4例，C组2例）死于原发性结直肠癌。在需要额外手术切除的病例中，T1期CRC的ER并未恶化临床结局。
Purpose Long-term outcomes of patients with T1 colorectal carcinoma (CRC) treated by endoscopic resection (ER) or surgical resection are unclear in relation to the curative criteria in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines. The aim of this study was to retrospectively compare the long-term outcomes among patients with T1 CRC in relation to the treatment methods.Methods We examined 322 T1 CRC cases treated between January 1992 and August 2008 at Hiroshima University Hospital. Patients who did not meet the curative criteria in the JSCCR guidelines were defined as "non-endoscopically curable" and classified into three groups: underwent ER alone (group A: 45 patients), underwent additional surgery after ER (group B: 106 patients), and underwent surgical resection alone (group C: 92 patients).Results Of the 322 T1 CRC patients, 79 were categorized as endoscopically curable and 243 as non-endoscopically curable. Among the endoscopically curable T1 CRC patients, recurrence and 5-year OS rates were 0 and 94.2 %, respectively. In groups A, B, and C, recurrence rates were 4.4, 6.6, and 4.3 %, and OS rates were 85.6, 95.1, and 96.3 %, respectively (p < 0.05). Local recurrence or distant/lymph node metastasis was observed in 13 patients (group A: 2; group B: 7; group C: 4). Death due to primary CRC occurred in six patients (group B: 4; group C: 2).Conclusion Long-term outcomes support the curative criteria according to the JSCCR guidelines. ER for T1 CRC did not worsen clinical outcomes in cases that required additional surgical resection.