Vertical margin distance in T1 colorectal carcinoma resected by endoscopic submucosal dissection affects prognosis after additional surgery.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-08-16 DOI:10.1007/s00384-024-04700-0
Fumiaki Tanino, Ken Yamashita, Shinji Nagata, Toshio Kuwai, Yuki Kamigaichi, Hidenori Tanaka, Yuzuru Tamaru, Hidehiko Takigawa, Naoki Asayama, Yuji Urabe, Fumio Shimamoto, Shiro Oka
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Abstract

PURPOSE : A vertical margin (VM) distance of < 500 µm is a risk factor for recurrence in patients with T1 colorectal carcinoma (CRC) resected by endoscopy. We aimed to determine the effects of the VM distance on the recurrence and prognosis of T1 CRC.

Methods: We enrolled 168 patients with T1 CRC who underwent additional surgery after endoscopic submucosal dissection (ESD) at multiple centers between 2008 and 2016. None of the patients were followed up for < 5 years. The enrolled 168 patients were classified into patients with VM distance of < 500 µm including positive VM (n = 72 [43%], VM distance < 500 µm group) and patients with VM distance of ≥ 500 µm (n = 96 [57%], VM distance ≥ 500 µm group). The clinicopathological features, recurrence rates, and prognoses were compared between the groups using propensity-score matching (PSM).

Results: Tumors recurred in eight of the 168 patients (5%) with VM distance < 500 µm. After PSM, the rate of overall recurrence and local recurrence in the VM distance < 500 µm group were significantly higher than those in the VM distance ≥ 500 µm group. The 5-year recurrence-free survival rate was significantly higher in the VM distance ≥ 500 µm group than that in VM distance < 500 µm group after PSM (100% vs. 89%, p < 0.012).

Conclusions: Complete en bloc resection of T1 CRC via ESD must include a sufficient amount of SM to reduce the risk of metastasis and recurrence after additional surgery.

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通过内镜黏膜下剥离术切除的 T1 结直肠癌的垂直边缘距离会影响追加手术后的预后。
目的 :垂直边缘(VM)距离的方法:2008年至2016年期间,我们在多个中心招募了168名T1型CRC患者,这些患者在内镜黏膜下剥离术(ESD)后接受了额外手术。所有患者均未接受随访:168例患者中有8例(5%)肿瘤复发,VM距离结论:通过ESD对T1 CRC进行完全全切必须包括足够量的黏膜下剥离,以降低转移和再次手术后复发的风险。
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来源期刊
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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