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[Endoscopic Therapy of Early Colorectal Cancer (pT1) - A Prospective Study]
P Frühmorgen1, W Rufle, S Kobras
1Medizinische Klinik I, Schwerpunkt Gastroenterologie/Hepatologie, Klinikum Ludwigsburg, Germany.
Zeitschrift Fur Gastroenterologie
|August 12, 2003
Summary
Endoscopic removal of low-risk pT1 colorectal cancer is effective, with low recurrence and mortality rates. This approach offers a safer alternative to surgery for select patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Investigating endoscopic treatment for early-stage colorectal cancer (pT1).
- Assessing the efficacy and safety of endoscopic management versus surgery.
Purpose of the Study:
- To determine if pT1 colorectal carcinomas can be treated exclusively via endoscopy.
- To evaluate outcomes of endoscopic treatment for low-risk and high-risk pT1 colorectal cancers.
Main Methods:
- Prospective study from 1982-2001, analyzing 144 pT1 colorectal carcinomas found in 5,470 endoscopic polyp removals.
- Patients were categorized into low-risk and high-risk groups based on tumor characteristics and resection margins.
- Follow-up of 120 patients for a mean of 46 months.
Main Results:
- 47 low-risk cases treated endoscopically showed a low recurrence rate (1/47).
- High-risk cases undergoing surgery had residual tumor or lymph node metastasis in 5/35 specimens.
- No tumor-related mortality was observed in endoscopically treated patients.
Conclusions:
- Endoscopic removal is adequate for low-risk pT1 colorectal tumors, with surveillance.
- Compared to surgery (3% mortality), endoscopy has lower risks (0.1% mortality, 1% lymph node metastasis).
- Endoscopic treatment followed by surveillance offers a safe and effective option for select pT1 colorectal cancer patients.