Long-Term Outcomes of Endoscopic Resection for T1 Colorectal Carcinomas

Aims The progress made over the past ten years in therapeutic endoscopy allows treating superficial colorectal cancers with low morbidity and no mortality. According to ESGE guidelines, additional surgery is required for high-risk tumors, i.e. with at least one of the four following histological risk factors: deep submucosal infiltration (> 1000µm), poorly differentiated tumor, lymphovascular invasion or high-grade tumor budding. We aimed to confirm the validity of these parameters in a Western population.

Methods We conducted a retrospective multicenter study in twelve French expert centers between March 2012 and July 2019, and included all patients with an endoscopic mucosal resection or an endoscopic submucosal dissection for a T1 colorectal cancer.

Results 271 patients were included. The median follow-up was 28.9 [18.4-42.2] months. 11 (4.1 %) patients had lymph node or metastatic recurrence and 8 (3.0 %) died. Among the 88 low-risk tumors, there was 1 lymph node recurrence and 2 non-cancer-related deaths. Among the 183 high-risk tumors, 3/68 (4.4 %) relapsed in the group of non-operated patients and 7/115 (6.1 %) in the group of operated patients (p = 0.63); 5/68 (7.4 %) died in the group of non-operated patients, among which 1/68 (1.5 %) cancer-related death, and 1/115 (0.9 %) died of a cancer-related death in the group of operated patients (p = 0.71). Recurrence-free survival curves comparison between low-risk and high-risk tumors showed a non-significant tendency (p = 0.13) to relapse more for high-risk tumors. Among these high-risk tumors, recurrence-free survival curves comparison between patients who had endoscopic resection alone and those who had endoscopic resection followed by additional surgery showed no difference (p = 0.69).

Conclusions This multicenter study of patients with endoscopically resected T1 colorectal cancers confirms the excellent oncological prognosis with this treatment modality, particularly for low-risk tumors. Complementary surgery did not provide any benefit in terms of recurrence-free survival in patients with high-risk tumors.

Citation: Corre F, Barret M, Lepilliez V et al. OP79 LONG-TERM OUTCOMES OF ENDOSCOPIC RESECTION FOR T1 COLORECTAL CARCINOMAS. Endoscopy 2021; 53: S34.

Publication History

Article published online:
19 March 2021