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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinicopathological features of small T1 colorectal cancers
Yuki Takashina, Shin-Ei Kudo, Katsuro Ichimasa, Yuta Kouyama, Kenichi Mochizuki, Yoshika Akimoto, Yasuharu Maeda, Yuichi Mori, Masashi Misawa, Noriyuki Ogata, Toyoki Kudo, Tomokazu Hisayuki, Takemasa Hayashi, Kunihiko Wakamura, Naruhiko Sawada, Toshiyuki Baba, Fumio Ishida, Kazunori Yokoyama, Mitsuru Daita, Tetsuo Nemoto, Hideyuki Miyachi
Yuki Takashina, Shin-Ei Kudo, Katsuro Ichimasa, Yuta Kouyama, Kenichi Mochizuki, Yoshika Akimoto, Yasuharu Maeda, Yuichi Mori, Masashi Misawa, Noriyuki Ogata, Toyoki Kudo, Tomokazu Hisayuki, Takemasa Hayashi, Kunihiko Wakamura, Naruhiko Sawada, Toshiyuki Baba, Fumio Ishida, Hideyuki Miyachi, Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan
Yuki Takashina, Kazunori Yokoyama, Mitsuru Daita, Department of Gastroenterology, Nikko Kinen Hospital, Muroran 051-8501, Japan
Yuichi Mori, Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo 0001, Norway
Tetsuo Nemoto, Department of Pathology, Showa University Nothern Yokohama Hospital, Yokohama 224-8503, Japan
Author contributions: Takashina Y, Kudo SE, Ichimasa K and Miyachi H did the study concept and design; Takashina Y, Ichimasa K, Kouyama Y, Mochizuki K, Akimoto Y, Maeda Y, Mori Y Misawa M, Ogata N, Kudo T, Hisayuki T, Hayashi T, Wakamura K, Sawada N, Baba T, Ishida F, Yokoyama K, Daita M, Nemoto T and Miyachi H Collected the data; Takashina Y, Mochizuki K, Maeda Y, Mori Y, Misawa M, Ogata N, Kudo T, Hisayuki T, Hayashi T, Wakamura K, Baba T, Ishida F and Miyachi H revised the article critically; Kudo SE and Miyachi H supervised the study.
Institutional review board statement: This study was approved by the institutional review board of Showa University Northern Yokohama Hospital, No. 19H057; and the University Hospital Medical Network Clinical Trials Registry No. UMIN000043922.
Informed consent statement: Written informed consent was obtained from all patients before treatment.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Katsuro Ichimasa, MD, PhD, Assistant Professor, Digestive Disease Center, Showa University Northern Yokohama Hospital, Tsuzuki-ku, chigasakichuou, 35-1, Yokohama 224-8503, Japan.
ichitommy14@yahoo.co.jp
Received: April 27, 2021
Peer-review started: April 27, 2021
First decision: June 13, 2021
Revised: June 14, 2021
Accepted: October 11, 2021
Article in press: October 11, 2021
Published online: November 26, 2021
Processing time: 208 Days and 11.8 Hours
BACKGROUND
Although small colorectal neoplasms (< 10 mm) are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms (≥ 10 mm), some are invasive to the submucosa.
AIM
To clarify the clinicopathological features of small T1 colorectal cancers.
METHODS
Of 32025 colorectal lesions between April 2001 and March 2018, a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size: a small group (< 10 mm) and a large group (≥ 10 mm). We compared clinicopathological factors including lymph node metastasis (LNM) between the two groups.
RESULTS
The incidence of small T1 cancers was 10.1% (116/1152). The percentage of initial endoscopic treatment in small group was significantly higher than in large group (< 10 mm 74.1% vs ≥ 10 mm 60.2%, P < 0.01). In the surgical resection cohort (n = 798), the rate of LNM did not significantly differ between the two groups (small 12.3% vs large 10.9%, P = 0.70). In addition, there were also no significant differences between the two groups in pathological factors such as histological grade, vascular invasion, or lymphatic invasion.
CONCLUSION
Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers, the requirement for additional surgical resection should be determined according to pathological findings, regardless of tumor size.
Core Tip: This is a retrospective study to evaluate the clinicopathological features in T1 colorectal cancers. We compared clinicopathological factors including lymph node metastasis (LNM) between the two groups: A small group (< 10 mm) and a large group (≥ 10 mm). Since there was no significant difference in the rate of LNM followed by histological grade, vascular invasion, or lymphatic invasion, between small and large T1 colorectal cancers, the requirement for additional surgical resection should be determined according to pathological findings, regardless of tumor size.
