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Long-term prognosis after treatment for T1 carcinoma of laterally spreading tumors: a multicenter retrospective study

  • Ken Yamashita
  • Shiro OkaEmail author
  • Shinji Tanaka
  • Shinji Nagata
  • Toshio Kuwai
  • Akira Furudoi
  • Tadamasa Tamura
  • Masaki Kunihiro
  • Hideharu Okanobu
  • Koichi Nakadoi
  • Hiroyuki Kanao
  • Makoto Higashiyama
  • Koji Arihiro
  • Kazuya Kuraoka
  • Fumio Shimamoto
  • Kazuaki Chayama
Original Article
  • 27 Downloads

Abstract

Purpose

Long-term prognosis of T1 laterally spreading tumors (LSTs) after treatment have not been clarified. This study compared clinicopathological characteristics and long-term prognosis of T1 LSTs.

Methods

We retrospectively assessed 169 patients with 169 T1 LSTs between January 1992 and December 2008 by ten hospitals. Patients who did not meet the Japanese Society for Cancer of the Colon and Rectum (JSCCR) 2016 guidelines for the treatment of colorectal carcinoma (CRC) criteria were defined as non-endoscopically curable. The number of non-endoscopically curable patients with LST-granular/ nodular mixed (LST-G-M) was 61, that with LST-non-granular/ flat elevated (LST-NG-FE) was 23, and that with LST-non-granular/ pseudo depressed (LST-NG-PD) was 23. Clinicopathological variables and long-term prognosis were analyzed.

Results

For overall patients, tumor size, number of non-endoscopically curable cases, and rate of submucosal invasion depth ≥ 1000 μm for the LST-G-M group were significantly higher than those in the other groups. For non-endoscopically curable patients, the tumor size for those with LST-G-M was significantly larger than those in the other groups. The rate of submucosal invasion width ≥ 4000 μm and type B/C muscularis mucosae with LST-G-M was higher than that with LST-NG-FE. All recurrences occurred in non-endoscopically curable patients with LST-G-M. Five-year overall and disease-free survivals for non-endoscopically curable patients with LST-G-M were significantly shorter than those for patients with non-endoscopically curable LST-NG-FE and PD.

Conclusions

Our data supported adequacy of the JSCCR guidelines for the treatment of CRC criteria for endoscopically curable patients after T1 LSTs treatment. Patients with T1 LST-G-M should be followed up more carefully.

Keywords

Laterally spreading tumor T1 colorectal carcinoma Treatment Recurrence Prognosis 

Notes

Compliance with ethical standards

This study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ken Yamashita
    • 1
  • Shiro Oka
    • 1
    Email author
  • Shinji Tanaka
    • 2
  • Shinji Nagata
    • 3
  • Toshio Kuwai
    • 4
  • Akira Furudoi
    • 5
  • Tadamasa Tamura
    • 6
  • Masaki Kunihiro
    • 7
  • Hideharu Okanobu
    • 8
  • Koichi Nakadoi
    • 9
  • Hiroyuki Kanao
    • 10
  • Makoto Higashiyama
    • 11
  • Koji Arihiro
    • 12
  • Kazuya Kuraoka
    • 13
  • Fumio Shimamoto
    • 14
  • Kazuaki Chayama
    • 1
  1. 1.Department of Gastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
  2. 2.Department of EndoscopyHiroshima University HospitalHiroshimaJapan
  3. 3.Department of GastroenterologyHiroshima City Asa Citizens HospitalHiroshimaJapan
  4. 4.Department of GastroenterologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterKureJapan
  5. 5.Department of GastroenterologyJA Hiroshima General HospitalHiroshimaJapan
  6. 6.Department of Internal MedicineHiroshima Memorial HospitalHiroshimaJapan
  7. 7.Department of Internal MedicineHiroshima City Hiroshima Citizens HospitalHiroshimaJapan
  8. 8.Department of GastroenterologyChugoku Rosai HospitalKureJapan
  9. 9.Department of GastroenterologyJA Onomichi General HospitalOnomichiJapan
  10. 10.Department of GastroenterologyHiroshima Red Cross Hospital & Atomic-bomb Survivors HospitalHiroshimaJapan
  11. 11.Department of GastroenterologyShobara Red Cross HospitalShobaraJapan
  12. 12.Department of Anatomical PathologyHiroshima University HospitalHiroshimaJapan
  13. 13.Department of Anatomical PathologyNational Hospital Organization Kure Medical Center and Chugoku Cancer CenterKureJapan
  14. 14.Faculty of Health SciencesHiroshima Shudo UniversityHiroshimaJapan

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