[Management and prognosis of patients with early colorectal cancer]

The controversy remains as to the management of patients with early colorectal cancer, especially criteria for subsequent surgical resection. However, all authors agree that residual carcinoma and lymph node metastasis closely affect survival of the patients. In this paper, we estimated the risk factor for local residual carcinoma or lymph node metastasis in early cancer, and wish to report the experience with particular reference to the management and prognosis of patients with invasive carcinoma. Subsequent surgery was indicated when the removed material showed at least one of the following findings: carcinoma near the surgical margin, massive invasion, vessel invasion and poorly differentiated adenocarcinoma. Patients without risk factors were adequately treated by polypectomy alone. Thirty-three percent of the patients with risk factors had residual carcinoma. We decided that massive invasion and carcinoma near the surgical margin were true risk factors for residual carcinoma. Only one patient with risk factors had lymph node metastasis. It is difficult to estimate the true risk of lymph node metastasis and further study is needed.