Polypectomy versus surgery in early colon cancer: size and location of colon cancer affect long-term survival

Gangireddy, Venu Gopala Reddy; Coleman, Teresa; Kanneganti, Praveen; Talla, Swathi; Annapureddy, Amarnath; Amin, Rajan; Parikh, Samip

doi:10.1007/s00384-018-3101-z

Cited by 25 publications

(17 citation statements)

References 20 publications

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“…The rate of LNM has been previously reported to range from 7-15% [5][6][7][8], which is higher than our findings. Previously, it has been established that LNM may be highly correlated with lympho-vascular invasion [10][11], tumor size [12][13][14][15][16][17], TB [18] ,tumor invading in submucosa [19][20][21][22][23][24] and pathological differentiation [25][26][27]. In our study, lympho-vascular invasion was identified to be an independent risk factor for LNM in ECC.…”

Section: Discussionsupporting

confidence: 60%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

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Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors for LNM and the effectiveness of postoperative chemotherapy in patients with ECC.MethodsWe retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January, 2007 and October, 2018. The correlations between LNM and gender, age, tumor size, tumor location, endoscopic morphology, Pathology, depth of invasion and tumor budding (TB), were estimated directly based on postoperative pathology results. We also observed the overall survivals (OS) and recurrences between ECC patients with and without LNM after the base-line being matched.Results There were 473 ECC patients observed, 288 patients of them were enrolled, 17 patients had LNM (5.90%). Univariate analysis revealed that tumor size, pathology, lympho-vascular invasion were associated with LNM in ECC (P = 0.026, 0.000, 0.000, respectively), and multivariate logistic regression confirmed that tumor size, pathology, lympho-vascular invasion were risk factors for LNM (P = 0.021, 0.023, 0.001, respectively). There were no significant differences for the OS and recurrence between the ECC patients with and without LNM whose base-lines were matched (P = 0.158,0.346, respectively), neither no significant difference between chemotherapy and no chemotherapy ECC patients without LNM after surgery (P = 0.729,0.052).Conclusion Tumor size, pathology, lympho-vascular invasion were risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve the overall survival and recurrence in patients with LNM, but no necessary for the ECC patients without LNM.

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Section: Discussionsupporting

confidence: 60%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The rate of LNM has been previously reported to range from 7-15% [5][6][7][8], which is higher than our ndings. Previously, it has been established that LNM may be highly correlated with lympho-vascular invasion [10][11], tumor size [12][13][14][15][16][17], TB [18] ,tumor invading in submucosa [19][20][21][22][23][24] and pathological differentiation [25][26][27]. In our study, lymphovascular invasion was identi ed to be an independent risk factor for LNM in ECC.…”

Section: Discussionsupporting

confidence: 55%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathology results. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

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“…A population-based study conducted in the U.S. reported no difference in the fiveyear survival rate between endoscopic resection and surgical treatment for mucosal or submucosal colorectal cancers (≤stage 1) with a longest diameter of ≤4 cm. 226 Mounzer et al also reported no difference in five-year colorectal cancer-specific recurrence-free survival rates (97.6% vs. 97.5%, p=0. 75) and colorectal cancer-specific mortalities (HR, 1.10; 95% CI, 0.72-1.69; p=0.65) between endoscopic resection and surgical treatment for colorectal cancer confined to the mucosa.…”

Section: Early Colorectal Cancermentioning

confidence: 93%

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

et al. 2020

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Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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Polypectomy versus surgery in early colon cancer: size and location of colon cancer affect long-term survival

Abstract: Polypectomy was as effective as surgical therapy for small tumors. For larger tumors, surgical therapy is better than polypectomy for right-sided tumors, but both are equally effective for left-sided tumors.

Cited by 25 publications

References 20 publications

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

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