Endoscopy 2020; 52(S 01): S231-S232
DOI: 10.1055/s-0040-1704723
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RISK OF LYMPH NODE METASTASIS IN PT1SM2 COLORECTAL CARCINOMA: RESULTS OF BICENTRIC RETROSPECTIVE STUDY

J Winkler
1   Paoli-Calmettes Institute, Marseille, France
,
JP Ratone
1   Paoli-Calmettes Institute, Marseille, France
,
A Lupu
2   Edouard Herriot Hospital, Lyon, France
,
E Bories
1   Paoli-Calmettes Institute, Marseille, France
,
F Caillol
1   Paoli-Calmettes Institute, Marseille, France
,
C Pesenti
1   Paoli-Calmettes Institute, Marseille, France
,
C Zemmour
1   Paoli-Calmettes Institute, Marseille, France
,
H Meillat
1   Paoli-Calmettes Institute, Marseille, France
,
F Poizat
1   Paoli-Calmettes Institute, Marseille, France
,
V Hervieu
2   Edouard Herriot Hospital, Lyon, France
,
T Ponchon
2   Edouard Herriot Hospital, Lyon, France
,
J Rivory
2   Edouard Herriot Hospital, Lyon, France
,
B Lelong
1   Paoli-Calmettes Institute, Marseille, France
,
C Dechaisemartin
1   Paoli-Calmettes Institute, Marseille, France
,
M Giovannini
1   Paoli-Calmettes Institute, Marseille, France
,
M Pioche
2   Edouard Herriot Hospital, Lyon, France
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims

Primary: Evaluate the recurrence-free survival rate in all patients and in pre-defined subgroups at 12 and 18 months.

Secondary: Measure the lymph node and/or metastatic invasion of operated colorectal adenocarcinoma pT1sm2, evaluate the rate of complete remission.

Methods Patients with endoscopic or surgical resection of colorectal adenocarcinoma pT1sm2 between 2012 and 2018 at Institut Paoli Calmettes (Marseille, France) and Hôpital Edouard Herriot (Lyon, France) were included. We chose to evaluate three groups:

1st: “supposedly good prognosis” group (SBP) included patient with endoscopic resection (ER) alone and all favorable pathological factors; patients with primary surgery, pT1sm2 and the same criteria; patients with an ER and additional surgery with pT0N0.

2nd: supposedly effective endoscopic resection (SEER)”: ER alone and no pejorative criteria, ER with additional surgery with pT0N0 and negative deep margins. 3rd group: Endoscopic resection alone with the 5 favorable pathological factors.

Results 69 patients were included with a median age of 68 years. The median follow-up was 18 months. 52 patients had the SBP group criteria, 12 had SEER and 6 had endoscopic resection alone. In the SBP group, the recurrence-free survival rate was 100% at 12 months and 96% compared to 85% and 75% for others patients (HR at 0.10 [0.01,0.93]; p < 0.044). Patients in the SEER group had a 100% and 80% survival rate without recurrence at 12 months and 18 months compared to 96 and 93% for others patients (p = 0.631). The “endoscopic resection alone” group, the recurrence-free survival rate at 18 months was 75% compared to 93% for other patients (p = 0.409). The complete remission rate was 100% for each group.

Conclusions Endoscopic resection of pT1sm2 adenocarcinoma without histological pejorative criteria might be a good candidate to avoid additional surgery. A longer follow-up and more patients are needed to confirm this approach.