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Long-term Outcomes after Endoscopic Resection in Submucosal Colorectal Cancer(Colon vs. Rectum) Hiroaki Ikematsu 1 , Yusuke Yoda 1 , Takahisa Matsuda 2 , Yuichiro Yamaguchi 3 , Kinichi Hotta 4 , Nozomu Kobayashi 5 , Takahiro Fujii 6 , Yasuhiro Oono 1 , Taku Sakamoto 2 , Takeshi Nakajima 2 , Madoka Takao 3 , Tomoaki Shinohara 4 , Takahiro Fujimori 7 , Kazuhiro Kaneko 1 , Yutaka Saito 2 1Department of Gastrointestinal Oncology & Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan 2Endoscopy Division, National Cancer Center Hospital, Tokyo 3Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan 4Department of Gastroenterology, Saku Central Hospital, Saku, Japan 5Department of Diagnostic Imaging, Tochigi Cancer Center, Tochigi, Japan 6Takahiro Fujii Clinic, Tokyo 7Diagnostic Pathology Center, Shinko Hospital, Kobe, Japan Keyword: 大腸T1癌 , 長期予後 , 再発率 pp.405-412
Published Date 2015/4/25
DOI https://doi.org/10.11477/mf.1403200206
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 The possible enlargement of the indicated organ post-endoscopic therapy for colorectal submucosal cancers has been discussed recently. However, little is known about the long-term outcomes of patients with submucosal invasive colorectal cancer who undergo endoscopic resection. We performed a retrospective analysis of the long-term outcomes of patients treated for submucosal colon and rectal cancer. A total of 787 patients with submucosal colorectal cancers who underwent endoscopic or surgical resection at 6 institutions were enrolled in the study, with a median follow-up period of 60.5 months. Patients were classified into one of the 3 groups : low-risk patients undergoing only endoscopic resection(Group A), high-risk patients undergoing only endoscopic resection(Group B), and high-risk patients undergoing surgical resection that included lymph node dissection(Group C). We assessed recurrence rates, 5-year disease-free survival, and 5-year overall survival. Cox regression analysis was used to compare recurrences. The rates of recurrence, disease-free survival, and overall survival in group A for submucosal colon and rectal cancer were 0% vs. 6.3%, 96% vs. 90%, and 96% vs. 89%, respectively. In group B for submucosal colon and rectal cancer, these values were 1.4% vs. 16.2%(p<.01), 96% vs. 77%(p<.01), and 98% vs. 96%, respectively. Tumor location was the only factor that contributed significantly to disease recurrence and death(hazard ratio, 6.73 ; p=.045). In group C for submucosal colon and rectal cancer, these values were 1.9% vs. 4.5%, 97% vs. 95%, and 99% vs. 97%, respectively. The risk of local recurrence was significantly higher in high-risk patients with submucosal rectal cancer than in those with submucosal colon cancer when treated with endoscopic resection.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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