Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer
Abstract Optimal management of T1 colorectal cancer (CRC) remains controversial. This study compared the long-term outcomes of endoscopic resection with additional surgical resection (ER + ASR) versus primary surgical resection (PS) in patients with T1 CRC and identified risk factors for lymph node...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-01-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-84915-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832585817626771456 |
|---|---|
| author | Pin-Chun Chen Yi-Kai Kao Po-Wen Yang Chia-Hung Chen Chih-I Chen |
| author_facet | Pin-Chun Chen Yi-Kai Kao Po-Wen Yang Chia-Hung Chen Chih-I Chen |
| author_sort | Pin-Chun Chen |
| collection | DOAJ |
| description | Abstract Optimal management of T1 colorectal cancer (CRC) remains controversial. This study compared the long-term outcomes of endoscopic resection with additional surgical resection (ER + ASR) versus primary surgical resection (PS) in patients with T1 CRC and identified risk factors for lymph node metastasis (LNM). This retrospective cohort study included 373 patients with T1 CRC who underwent ER + ASR or PS between January 2010 and December 2020 at a tertiary center in Taiwan. Surgical and oncological outcomes, including recurrence rates, LNM, 5-year overall survival (OS), and 5-year recurrence-free survival (RFS) were compared. Univariate and multivariate analyses identified risk factors for LNM. No significant differences were observed between the ER + ASR and PS groups in surgical outcomes, recurrence rates, LNM, 5-year OS (93% vs. 89%, P = 0.18), or 5-year RFS (89% vs. 88%, P = 0.47). Patients with ≥ 2 high-risk factors had significantly lower 5-year OS and RFS compared to those with ≤ 1 risk factor (p < 0.01). Poor histology grade and lymphovascular invasion were independent risk factors for LNM. ER + ASR and PS had comparable long-term outcomes in patients with T1 CRC. A multidisciplinary approach and standardized protocols are required for optimal management of early-stage CRC. |
| format | Article |
| id | doaj-art-f47a292f71ba4510b6d1a3ed881cc82e |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-f47a292f71ba4510b6d1a3ed881cc82e2025-01-26T12:30:00ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-024-84915-xLong-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancerPin-Chun Chen0Yi-Kai Kao1Po-Wen Yang2Chia-Hung Chen3Chih-I Chen4Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou UniversityDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou UniversityDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou UniversityDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou UniversityDivision of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou UniversityAbstract Optimal management of T1 colorectal cancer (CRC) remains controversial. This study compared the long-term outcomes of endoscopic resection with additional surgical resection (ER + ASR) versus primary surgical resection (PS) in patients with T1 CRC and identified risk factors for lymph node metastasis (LNM). This retrospective cohort study included 373 patients with T1 CRC who underwent ER + ASR or PS between January 2010 and December 2020 at a tertiary center in Taiwan. Surgical and oncological outcomes, including recurrence rates, LNM, 5-year overall survival (OS), and 5-year recurrence-free survival (RFS) were compared. Univariate and multivariate analyses identified risk factors for LNM. No significant differences were observed between the ER + ASR and PS groups in surgical outcomes, recurrence rates, LNM, 5-year OS (93% vs. 89%, P = 0.18), or 5-year RFS (89% vs. 88%, P = 0.47). Patients with ≥ 2 high-risk factors had significantly lower 5-year OS and RFS compared to those with ≤ 1 risk factor (p < 0.01). Poor histology grade and lymphovascular invasion were independent risk factors for LNM. ER + ASR and PS had comparable long-term outcomes in patients with T1 CRC. A multidisciplinary approach and standardized protocols are required for optimal management of early-stage CRC.https://doi.org/10.1038/s41598-024-84915-xT1 colorectal cancerEndoscopic resectionSurgical resectionRisk stratificationLymph node metastasis |
| spellingShingle | Pin-Chun Chen Yi-Kai Kao Po-Wen Yang Chia-Hung Chen Chih-I Chen Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer Scientific Reports T1 colorectal cancer Endoscopic resection Surgical resection Risk stratification Lymph node metastasis |
| title | Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer |
| title_full | Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer |
| title_fullStr | Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer |
| title_full_unstemmed | Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer |
| title_short | Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer |
| title_sort | long term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for t1 colorectal cancer |
| topic | T1 colorectal cancer Endoscopic resection Surgical resection Risk stratification Lymph node metastasis |
| url | https://doi.org/10.1038/s41598-024-84915-x |
| work_keys_str_mv | AT pinchunchen longtermoutcomesandlymphnodemetastasisfollowingendoscopicresectionwithadditionalsurgeryorprimarysurgeryfort1colorectalcancer AT yikaikao longtermoutcomesandlymphnodemetastasisfollowingendoscopicresectionwithadditionalsurgeryorprimarysurgeryfort1colorectalcancer AT powenyang longtermoutcomesandlymphnodemetastasisfollowingendoscopicresectionwithadditionalsurgeryorprimarysurgeryfort1colorectalcancer AT chiahungchen longtermoutcomesandlymphnodemetastasisfollowingendoscopicresectionwithadditionalsurgeryorprimarysurgeryfort1colorectalcancer AT chihichen longtermoutcomesandlymphnodemetastasisfollowingendoscopicresectionwithadditionalsurgeryorprimarysurgeryfort1colorectalcancer |