Issues to be Solved in the JSCCR Guidelines 2009 for Improved Treatment Strategy for Endoscopically Resected T1 Colorectal Cancer Hideki Ueno 1 , Yojiro Hashiguchi 1 , Eiji Shinto 1 , Yoshihisa Naito 1 , Hidetaka Mochizuki 2 , Kazuo Hase 1 1Department of Surgery, National Defense Medical College, Tokorozawa, Japan 2Director of National Defense Medical College Hospital, Tokorozawa, Japan Keyword: 大腸SM癌 , 大腸癌治療ガイドライン , リンパ節再発 , 追加腸切除 , SM浸潤度 pp.1449-1452
Published Date 2011/9/25
DOI https://doi.org/10.11477/mf.1403102352
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 We can enumerate three points as the issues to be solved concerning the treatment strategy for endoscopically resected T1 CRC(colorectal cancer)proposed in the JSCCR Guidelines 2009. first, interobserver disagreement in histopathologic assessment of risk parameters. second, problems concerning an excessive number of patients undergoing unnecessary laparotomy under the current surgical indication. third, few existing surveillance systems for patients under conservative treatment for endoscopically resected T1 CRC.

 Concerning the first point, we can expect on-going JSCCR multicenter studies to improve the consistency of interobserver judgment. With regard to the second point,JSCCR has launched multicenter study to establish the stratification system of risk of lymph node metastasis of T1 CRC, when using conventional pathological factors. On the top of this trial, an attempt to establish novel pathological criteria reflecting the biological reactions of tumors is needed for the efficient selection of the high-risk T1 CRC. Regarding the third point concerning the establishment of an optimal surveillance program, multicenter studies are needed to clarify the actual status of recurrence of T1 CRC patients under conservative treatment after endoscopic resection.

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