Abstract
The Indication for Additional Surgical Colectomy With Lymph Node Dissection After Endoscopic Treatment in T1 Colorectal Carcinomas Hideyuki Miyachi*, Shin-Ei Kudo, Shigeharu Hamatani, Katsuro Ichimasa, Tomokazu Hisayuki, Yuta Kouyama, Hiromasa Oikawa, Shingo Matsudaira, Yuichi Mori, Masashi Misawa, Toyoki Kudo, Shunpei Mukai, Kenta Kodama, Kunihiko Wakamura, Takemasa Hayashi, Eiji Hidaka, Shogo Ohkoshi, Haruhiro Inoue, Fumio Ishida Digestive Disease Center, Showa Univercity Northern Yokohama Hospital, Yokohama, Japan; Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan Background: Recent advances in EMR or ESD technology has enabled easier and safer endoscopic treatment. A lot of T1 colorectal carcinomas are resected endoscopically with negative margins. Therefore, additional surgical colectomy with lymph node dissection should be considered according to the pathological analysis. Although it is critical to determine the criteria for curative endoscopic resection, there is only a few data pursuing a large number of samplings in terms of the indication for additional surgical colectomy. Aims: The aim is to clarify pathological risk factors for lymph node metastasis of T1 colorectal carcinomas and to establish the indication for additional surgical colectomy with nodal dissection after endoscopic treatment. Methods: A total of 20072 colorectal neoplasms excluding advanced cancers have been resected endoscopically or surgically at our unit from April 2001 to May 2013. Of these, 853 T1 carcinomas were included. Initial or additional surgical colectomy with nodal dissection was performed in 563 cases, and of which lymph node metastasis was found in 52 cases (9.2%). We analyzed the pathological risk factors for nodal metastasis as follows: vessel permeation, tumor budding, poorly-differentiated/mucinous carcinoma (POR/MUC) component, desAbstracts
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