T1 COLORECTAL CANCER TREATED BY ENDOSCOPIC RESECTION: IS THE PROGNOSIS DIFFERENT BETWEEN RECTAL AND COLON TUMORS?

Aims Several studies suggest that rectal tumors have a poorer prognosis than colon tumors. The objective of this study was to compare the prognosis between T1 colon cancers and T1 rectal cancers treated by endoscopic resection.

Methods We conducted a retrospective study including patients who had endoscopic resection for T1 colorectal cancer in fourteen French expert centers between March 2012 and July 2019.

Results 462 patients were included. The mean age was 67.2+/- 11.4. 207/462(44.8%) patients had rectal tumor and 255/462(55.2%) had colon tumor. There were significantly more Paris 0-Ip pedunculated polyps among the colon tumors 72/255(28.2%) than among the rectal tumors 7/205(3.4%) p<0.001. There were significantly more endoscopic submucosal dissections among rectal tumors 142/207(68.6%) than among colon tumors 72/254(28.3%) p<0.001. Concerning the prognosis, among the 225/462(48.7%) patients who underwent additional surgery, there were significantly more lymph node involvements in rectal tumors 16/84(19.0%) than in colon tumors 14/141(9.9%) p=0.05. In contrast, there was no statistically significant difference in terms of cancer recurrence during follow-up between colon 6/255(2.4%) and rectal tumors 7/207(3.4%) p=0.506. In multivariate analysis, only poor differentiation (p=0.009) and lymphovascular invasion (p=0.031) were significant in predicting lymph node involvement. On the other hand, tumor location (p=0.424) as well as the other usual histological risk factors such as high-grade budding (p=0.202) and deep submucosal invasion (p=0.815) were not significant in multivariate analysis to predict lymph node involvement.

Conclusions In terms of prognosis, it seems unnecessary to differentiate rectal and colon location of T1 colorectal cancers treated by endoscopic resection.

Publication History

Article published online:
14 April 2022