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Z Gastroenterol 2015; 53(04): 291-301
DOI: 10.1055/s-0034-1385764
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Impact of revisions of the JSCCR guidelines on the treatment of T1 colorectal carcinomas in Japan

Auswirkungen von Änderungen der JSCCR-Leitlinien für die Behandlung von kolorektalen T1-Karzinomen in Japan
Y. Urabe
1   Endoscopy, Hiroshima University, Hiroshima
,
S. Tanaka
1   Endoscopy, Hiroshima University, Hiroshima
,
Y. Saito
2   Endoscopy, National Cancer Center Hospital, Tokyo
,
M. Igarashi
3   Gastroenterology, Cancer Institute Ariake Hospital, Tokyo
,
T. Watanabe
4   Surgical Oncology, Tokyo University, Tokyo
,
K. Sugihara
5   Surgical Oncology, Graduate School of Tokyo Medical and Dental University, Tokyo
› Author Affiliations
Further Information

Publication History

01 August 2014

23 November 2014

Publication Date:
10 April 2015 (online)

Also available at
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Abstract

Purpose: In 1977, the Japanese Society for Cancer of the Colon and Rectum (JSCCR) published the first edition of the general guidelines that described how to record clinical and histopathological findings of colorectal carcinomas (CRCs) and how to treat these cancers, and since then, the guidelines were revised several times. The aim of this study was to examine the impact of the revisions of the JSCCR guidelines on the treatment of submucosal CRCs (T1-CRCs) in Japanese clinical settings.

Methods: Questionnaires were sent to all 391 member institutions of the JSCCR. The questionnaires consisted of 2 parts: details of the institutions and treatment strategies for T1-CRCs.

Results: 73 (19 %) institutions responded to the survey. The number of treated T1-CRCs has increased year by year, and the rate of endoscopic resection for T1-CRCs has significantly increased with revisions of the guidelines (1417 [47 %] of 2985 T1-CRCs in 2003 – 2005, 2110 [50 %] of 4212 in 2006 – 2008, and 2546 [54 %] of 4686 in 2009 – 2011, P<.05).

Conclusion: The revisions of the JSCCR guidelines have influenced the treatment of T1-CRCs in Japanese clinical settings. There is room to revise the criteria for curative endoscopic resection to avoid unnecessary surgeries.

Zusammenfassung

Ziel: Im Jahr 1977 veröffentlichte die Japanese Society for Cancer of the Colon and Rectum (JSCCR) die erste Ausgabe der allgemeinen Leitlinien über die Dokumentation von histopathologischen Befunden und die Behandlung kolorektaler Karzinome (KRK). Seitdem wurden die Leitlininen mehrfach überarbeitet. Ziel dieser Studie war es, den Einfluss der Revisionen der JSCCR-Leitlinien auf die Behandlung von KRKs der Submukosa (T1-Karzinome) im klinischen Umfeld in Japan zu untersuchen.

Methoden: An alle 391 Mitgliedseinrichtungen der JSCCR wurden Fragebögen versandt. Diese bestanden aus zwei Teilen: genaue Angaben zur Einrichtung und Behandlungsstrategien für T1-Karzinome.

Ergebnisse: 73 Institutionen (19 %) beantworteten die Umfrage. Die Anzahl der behandelten T1-Karzinome hat jedes Jahr zugenommen und der Anteil der endoskopischen Resektionen von T1-Karzinomen ist mit den Revisionen der Leitlinien signifikant gestiegen (1417 [47 %] von 2985 T1-Karzinomen in den Jahren 2003 – 2005, 2110 [50 %] von 4212 in den Jahren 2006 – 2008, und 2546 [54 %] von 4686 in den Jahren 2009 – 2011, P<.05).

Schlussfolgerung: Die Revisionen der JSCCR-Leitlinien haben die Behandlung von kolorektalen T1-Karzinomen im klinischen Umfeld in Japan beeinflusst. Die Überprüfung der Kriterien für kurative endoskopische Resektionen wäre wünschenswert, um überflüssige Eingriffe zu vermeiden.

Schlüsselwörter

kolorektale T1-Karzinome - Fragebogen - endoskopische Resektion - zusätzliche chirurgische Resektion - JSCCR-Richtlinien 2005 - JSCCR-Richtlinien 2009/10

Key words

T1 colorectal carcinoma - questionnaires - endoscopic resection - additional surgical resection - JSCCR guideline 2005 - JSCCR guideline 2009/10
 

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