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Risk for Incomplete Resection after Macroscopic Radical Endoscopic Resection of T1 Colorectal Cancer: A Multicenter

Y Backes1, W H de Vos Tot Nederveen Cappel2, J van Bergeijk3

  • 1Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.

The American Journal of Gastroenterology
|March 22, 2017
PubMed
Summary
This summary is machine-generated.

Piecemeal resection and non-pedunculated morphology increase the risk of incomplete endoscopic resection for T1 colorectal cancer (CRC). A

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Cancer Research

Background:

  • Endoscopic resection is a primary treatment for T1 colorectal cancer (CRC).
  • Secondary surgery decisions hinge on lymph node metastasis and complete resection risks.
  • Identifying factors for incomplete resection is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of incomplete endoscopic resection in T1 CRC.
  • To identify independent risk factors for incomplete resection after macroscopic radical endoscopic resection.

Main Methods:

  • Retrospective analysis of 877 patients with T1 CRC undergoing endoscopic resection (2000-2014).
  • Incomplete resection defined by local recurrence or malignant tissue in surgical specimens.
  • Multivariate regression analysis to identify associated factors.

Main Results:

  • Incomplete resection occurred in 3.4% of patients.
  • High-risk T1 CRC had a significantly higher incomplete resection rate (4.4%) compared to low-risk (0.7%).
  • Piecemeal resection (OR 2.60) and non-pedunculated morphology (OR 2.18) were independent risk factors for incomplete resection.

Conclusions:

  • A 'wait-and-see' approach is suitable for T1 CRC without high-risk histological factors.
  • Piecemeal resection and non-pedunculated morphology are key predictors of incomplete endoscopic resection.
  • These findings aid in refining treatment strategies for T1 CRC.