Long-Term Outcomes of Additional Surgery After Endoscopic Resection Versus Primary Surgery for T1 Colorectal Cancer

被引：1

作者：

Tamaru, Yuzuru ^{[1
,2
]}

Kuwai, Toshio ^{[1
,2
,3
]}

Kajiwara, Yoshiki ^{[4
]}

Oka, Shiro ^{[5
]}

Saito, Shoichi ^{[6
]}

Fukunaga, Yosuke ^{[7
]}

Kawachi, Hiroshi ^{[8
]}

Takamatsu, Manabu ^{[8
]}

Hotta, Kinichi ^{[9
]}

Ikematsu, Hiroaki ^{[10
]}

Kojima, Motohiro ^{[11
]}

Saito, Yutaka ^{[12
]}

Kanemitsu, Yukihide ^{[13
]}

Yamada, Masayoshi ^{[12
]}

Sekine, Shigeki ^{[14
]}

Tanaka, Shinji ^{[5
]}

Nagata, Shinji ^{[15
]}

Nakamura, Takahiro ^{[16
]}

Yamada, Kazutaka ^{[17
]}

Konno, Maki ^{[18
]}

Ishihara, Soichiro ^{[19
]}

Saitoh, Yusuke ^{[20
]}

Matsuda, Kenji ^{[21
]}

Togashi, Kazutomo ^{[22
]}

Komori, Koji ^{[23
]}

Ishiguro, Megumi ^{[24
]}

Okuyama, Takashi ^{[25
]}

Ohuchi, Akihiro ^{[26
]}

Ohnuma, Shinobu ^{[27
]}

Sakamoto, Kazuhiro ^{[28
]}

Sugai, Tamotsu ^{[29
]}

Katsumata, Kenji ^{[30
]}

Matsushita, Hiro-o ^{[31
]}

Yamano, Hiro-o ^{[32
]}

Nakai, Keisuke ^{[33
]}

Uraoka, Toshio ^{[34
]}

Akimoto, Naohiko ^{[35
]}

Kobayashi, Hirotoshi ^{[36
]}

Ajioka, Yoichi ^{[37
]}

Sugihara, Kenichi ^{[38
]}

Ueno, Hideki ^{[4
]}

机构：

[1] Natl Hosp Org Kure Med Ctr, Dept Gastroenterol, Kure, Japan

[2] Chugoku Canc Ctr, Kure, Japan

[3] Hiroshima Univ Hosp, Gastrointestinal Endoscopy & Med, Hiroshima, Japan

[4] Natl Def Med Coll, Dept Surg, Tokorozawa, Saitama, Japan

[5] Hiroshima Univ Hosp, Dept Endoscopy, Hiroshima, Japan

[6] Japanese Fdn Canc Res, Canc Inst Hosp, Tokyo, Japan

[7] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Colorectal Surg, Tokyo, Japan

[8] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Pathol, Tokyo, Japan

[9] Shizuoka Canc Ctr, Div Endoscopy, Sunto, Japan

[10] Natl Canc Ctr Hosp East, Dept Gastroenterol & Endoscopy, Kashiwa, Japan

[11] Natl Canc Ctr, Exploratory Oncol Res & Clin Trial Ctr, Div Pathol, Kashiwa, Chiba, Japan

[12] Natl Canc Ctr, Div Endoscopy, Tokyo, Japan

[13] Natl Canc Ctr Hosp East, Dept Colorectal & Pelv Surg, Tokyo, Japan

[14] Natl Canc Ctr, Clin Lab Div, Tokyo, Japan

[15] Hiroshima City Asa Citizens Hosp, Dept Gastroenterol, Hiroshima, Japan

[16] Natl Def Med Coll, Lab Math, Tokorozawa, Saitama, Japan

[17] Takano Hosp, Coloproctol Ctr, Kumamoto, Japan

[18] Tochigi Canc Ctr, Dept Gastroenterol, Utsunomiya, Tochigi, Japan

[19] Univ Tokyo, Dept Surg Oncol, Tokyo, Japan

[20] Asahikawa City Hosp, Digest Dis Ctr, Asahikawa, Hokkaido, Japan

[21] Wakayama Med Univ, Sch Med, Dept Surg 2, Wakayama, Japan

[22] Fukushima Med Univ, Aizu Med Ctr, Dept Coloproctol, Aizu Wakamatsu, Fukushima, Japan

[23] Aichi Canc Ctr Hosp, Dept Gastroenterol Surg, Nagoya, Aichi, Japan

[24] Tokyo Med & Dent Univ, Med Innovat Promot Ctr, Tokyo, Japan

[25] Dokkyo Med Univ, Saitama Med Ctr, Dept Surg, Saitama, Japan

[26] Kurume Univ, Sch Med, Dept Pathol, Kurume, Japan

[27] Tohoku Univ, Grad Sch Med, Dept Surg, Sendai, Japan

[28] Juntendo Univ, Fac Med, Dept Coloproctol Surg, Tokyo, Japan

[29] Iwate Med Univ, Dept Mol Diagnost Pathol, Sch Med, Shiwa, Japan

[30] Tokyo Med Univ, Dept Gastrointestinal & Pediat Surg, Tokyo, Japan

[31] Akita Red Cross Hosp, Ctr Digest Dis, Akita, Japan

[32] Sapporo Med Univ, Dept Gastroenterol & Hepatol, Sch Med, Sapporo, Hokkaido, Japan

[33] Hyogo Coll Med, Dept Internal Med, Nishinomiya, Hyogo, Japan

[34] Natl Hosp Org, Tokyo Med Ctr, Dept Gastroenterol, Tokyo, Japan

[35] Nippon Med Sch, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[36] Tokyo Metropolitan Hiroo Gen Hosp, Dept Surg, Tokyo, Japan

[37] Niigata Univ, Grad Sch Med & Dent Sci, Div Mol & Diagnost Pathol, Niigata, Japan

[38] Japan Acad, Tokyo, Japan

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2024年 / 119卷 / 12期

关键词：

T1; colorectal cancer; overall survival; recurrence; endoscopic resection; RECURRENCE-FREE SURVIVAL; JAPANESE SOCIETY; SURGICAL RESECTION; POLYPS; COLON; RISK; MANAGEMENT; TUMOR; RECOMMENDATIONS; POLYPECTOMY;

D O I：

10.14309/ajg.0000000000002879

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

INTRODUCTION:There is considerable concern about whether endoscopic resection (ER) before additional surgery (AS) for T1 colorectal cancer (CRC) has oncologically potential adverse effects. Therefore, the aim of this study was to compare the long-term outcomes, including overall survival (OS), of patients treated with AS after ER vs primary surgery (PS) for T1 CRC using a propensity score-matched analysis from a large observational study.METHODS:This study investigated 6,105 patients with T1 CRC treated with either ER or surgical resection between 2009 and 2016 at 27 high-volume Japanese institutions, with those undergoing surgery alone included in the PS group and those undergoing AS after ER included in the AS group. Propensity score matching was used for long-term outcomes of mortality and recurrence analysis.RESULTS:After propensity score matching, 1,219 of 2,438 patients were identified in each group. The 5-year OS rates in the AS and PS groups were 97.1% and 96.0%, respectively (hazard ratio: 0.72, 95% confidence interval: 0.49-1.08), indicating the noninferiority of the AS group. Moreover, 32 patients (2.6%) in the AS group and 24 (2.0%) in the PS group had recurrences, with no significant difference between the 2 groups (odds ratio: 1.34, 95% confidence interval: 0.76-2.40, P = 0.344).DISCUSSION:ER before AS for T1 CRC had no adverse effect on patients' long-term outcomes, including the 5-year OS rate. ER is a viable first-line treatment option for endoscopically resectable T1 CRC.

引用

页码：2418 / 2425

页数：8

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