Scholarlink

Objectives <p>The oncologic outcomes of pedunculated-type T1 colorectal cancer (CRC) remain unknown. We determined the risk factors for lymph node metastasis (LNM) and recurrence and evaluated the survival according to the treatment method.</p> Methods <p>In this multicenter retrospective study involving 4673 patients with T1 CRC, we analyzed 444 patients with pedunculated-type T1 CRC treated between 2009 and 2016. Treatment included local resection (LR) alone (<i>n</i> = 169), surgery with lymph node (LN) dissection alone (<i>n</i> = 83), and LR followed by additional surgery with LN dissection (<i>n</i> = 192). Factors associated with LNM and recurrence, relapse-free survival (RFS) and overall survival (OS) by treatment were analyzed. The median follow-up period was 64&#xa0;months.</p> Results <p>LNM and recurrence were observed in 25 (5.6%) and 13 (2.9%) cases, respectively. Submucosal invasion depth ≥ 1000&#xa0;μm (<i>p</i> = 0.0036), positive lymphovascular invasion (<i>p</i> = 0.0007), and budding grade 2/3 (<i>p</i> = 0.0171) were risk factors for LNM. The risk factor for recurrence was tumor size ≥ 20&#xa0;mm (HR 5.488; 95% CI 1.199–25.12; <i>p</i> = 0.028) in a multivariate analysis. The 5-year RFS rates were 92.5% for LR alone, 94.3% for LR+ surgery, and 90.5% for surgery alone; the 5-year OS rates were 93.1%, 97.1%, and 94.0%, respectively, with no significant difference.</p> Conclusion <p>Even in the specific subset of pedunculated-type T1 CRC, submucosal invasion depth ≥ 1000&#xa0;μm and budding grade 2/3 are risk factors for LNM. Tumors ≥ 20&#xa0;mm require careful surveillance for recurrence risk. High RFS and OS rates in LR-alone and LR+ surgery groups suggest LR is appropriate for pedunculated lesions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictors of lymph node metastases, recurrence, and survival in patients with pedunculated-type T1 colorectal cancer

  • 期刊论文

  • 发表日期：

    2025年11月20日

查看全文
  • Kengo Kasuga,
  • Toshio Uraoka,
  • Yoshiki Kajiwara,
  • Shiro Oka,
  • Shinji Tanaka,
  • Takahiro Nakamura,
  • Shoichi Saito,
  • Yosuke Fukunaga,
  • Manabu Takamatsu,
  • Hiroshi Kawachi,
  • Kinichi Hotta,
  • Hiroaki Ikematsu,
  • Motohiro Kojima,
  • Yutaka Saito,
  • Yukihide Kanemitsu,
  • Shigeki Sekine,
  • Shinji Nagata,
  • Kazutaka Yamada,
  • Jun Konishi,
  • Soichiro Ishihara,
  • Yusuke Saitoh,
  • Kenji Matsuda,
  • Kazutomo Togashi,
  • Koji Komori,
  • Megumi Ishiguro,
  • Toshio Kuwai,
  • Takashi Okuyama,
  • Akihiro Ohuchi,
  • Shinobu Ohnuma,
  • Kazuhiro Sakamoto,
  • Tamotsu Sugai,
  • Kenji Katsumata,
  • Hiro-O. Matsushita,
  • Hiro-O. Yamano,
  • Keisuke Nakai,
  • Naohiko Akimoto,
  • Hirotoshi Kobayashi,
  • Yoichi Ajioka,
  • Kenichi Sugihara,
  • Hideki Ueno

摘要

Objectives

The oncologic outcomes of pedunculated-type T1 colorectal cancer (CRC) remain unknown. We determined the risk factors for lymph node metastasis (LNM) and recurrence and evaluated the survival according to the treatment method.

Methods

In this multicenter retrospective study involving 4673 patients with T1 CRC, we analyzed 444 patients with pedunculated-type T1 CRC treated between 2009 and 2016. Treatment included local resection (LR) alone (n = 169), surgery with lymph node (LN) dissection alone (n = 83), and LR followed by additional surgery with LN dissection (n = 192). Factors associated with LNM and recurrence, relapse-free survival (RFS) and overall survival (OS) by treatment were analyzed. The median follow-up period was 64 months.

Results

LNM and recurrence were observed in 25 (5.6%) and 13 (2.9%) cases, respectively. Submucosal invasion depth ≥ 1000 μm (p = 0.0036), positive lymphovascular invasion (p = 0.0007), and budding grade 2/3 (p = 0.0171) were risk factors for LNM. The risk factor for recurrence was tumor size ≥ 20 mm (HR 5.488; 95% CI 1.199–25.12; p = 0.028) in a multivariate analysis. The 5-year RFS rates were 92.5% for LR alone, 94.3% for LR+ surgery, and 90.5% for surgery alone; the 5-year OS rates were 93.1%, 97.1%, and 94.0%, respectively, with no significant difference.

Conclusion

Even in the specific subset of pedunculated-type T1 CRC, submucosal invasion depth ≥ 1000 μm and budding grade 2/3 are risk factors for LNM. Tumors ≥ 20 mm require careful surveillance for recurrence risk. High RFS and OS rates in LR-alone and LR+ surgery groups suggest LR is appropriate for pedunculated lesions.