单独进行内镜切除作为低风险的深度侵入性T1结直肠癌的潜在治疗方法
Yuta Kouyama1, Shin-Ei Kudo1, Katsuro Ichimasa1,2
1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
iGIE : innovation, investigation and insights
|February 6, 2026
概括
单独进行内镜切除可能足以治疗低风险T1b结肠直肠癌 (CRC). 这种方法没有显示淋巴结转移或复发,这表明它是.
科学领域:
- 胃肠病学和肝病学
- 手术瘤学手术瘤学
- 结肠直肠癌研究研究
背景情况:
- 目前的指导方针建议为T1b结直肠癌 (CRC) 进行淋巴结剖析的手术切除.
- 然而,T1b入侵与淋巴结转移 (LNM) 相比,与其他危险因素相比,与淋巴结转移的相关性较弱.
- 低风险的T1b CRC,定义为T1b入侵而没有其他不良特征,可能不需要进行广泛的手术.
研究的目的:
- 评估低风险T1b CRC.患者手术切除的必要性.
- 评估淋巴结转移 (LNM),复发和长期结果的风险.
- 确定单独进行内镜切除是否是这个患者群体的可行的替代方案.
主要方法:
- 在2001年4月至2019年3月期间切除的1271例T1CRC病例的回顾性分析.
- 专注于354名低风险T1bCRC患者,将单独内切除 (单独ER组,n=105) 与手术切除 (SR组,n=249) 相比较.
- 在两组中评估LNM病例率,累积复发率和整体存活率 (OS).
主要成果:
- 在单独ER组 (0%) 或SR组 (0%) 中没有观察到淋巴结转移 (LNM).
- 单独ER组和SR组的五年累计复发率为0%.
- 五年整体存活率 (OS) 是可比的:单独ER的93%和SR的95% (P = .35).
结论:
- 单独进行内镜切除 (ER) 似乎是选择患有低风险T1b结肠直肠癌的患者的安全有效治疗方法.
- 这种方法在LNM,复发和生存方面显示了与手术切除相似的结果.
- 进一步考虑单独使用ER作为低风险T1bCRC的治疗选择是合理的.
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