AGA Clinical Practice Update on Endoscopic Resection for Early Colorectal Cancer: Commentary

T1 colorectal cancer (CRC), defined as tumor invasion confined to the submucosa, has traditionally been managed by surgery. Advances in endoscopic resection techniques, coupled with an improved understanding of tumor biology and risk of lymph node metastasis and recurrence, have expanded our treatment armamentarium for these lesions. The purpose of this American Gastroenterological Association (AGA) Clinical Practice Update Expert Commentary is to review the definition of T1 CRC, discuss the role of endoscopic resection for these lesions, review factors associated with risk of recurrence and metastasis, and discuss post-resection management, including surveillance or adjuvant surgery. The target audience for this commentary includes primary care, gastroenterology, pathology, and surgical health care professionals.

This expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology.