ArticleGut2018
Endoscopic resection of high-risk T1 colorectal carcinoma prior to surgical resection has no adverse effect on long-term outcomes.
Article in Gut, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04150081 (Endoscopic Versus Surgical Treatment for T1 Colorectal Cancer), which is not on this map. Cited by 54 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Endoscopic Versus Surgical Treatment for T1 Colorectal Cancer: a Population-based Cohort Study
Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Endoscopic resection versus surgery for T1 rectal cancer: A systematic review and meta-analysis of oncologic and safety outcomes.Surgical endoscopy · 2026Pooled it
- Prior endoscopic resection does not affect the outcome of secondary surgery for T1 colorectal cancer, a systematic review and meta-analysis.International journal of colorectal disease · 2022Pooled it
- Competing Mortality Redefines the Net Benefit of Additional Surgery After Endoscopic Resection for T1 Colorectal Cancer in Older Adults.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Review
- Utility of quantitative pathologic analysis of pT1 colorectal carcinomas to improve prediction of lymph node metastasis.Virchows Archiv : an international journal of pathology · 2026Article
- Artificial Intelligence in Gastrointestinal Endoscopy and Hemostatic Decision-Making: Current Evidence, Clinical Implications and Implementation Barriers.Life (Basel, Switzerland) · 2026Review
- Which prognostic factors for recurrence after transanal endoscopic microsurgery for early rectal cancer?Surgical endoscopy · 2026Article
- Depth of Tumor Invasion (T-Stage) is Not Associated with Survival or Recurrence Rates in Patients Undergoing Surgery for pT1 and pT2 Colon Cancer.Annals of surgical oncology · 2026Article
- Does Omitting Additional Surgery After Local Resection Affect Oncological Outcomes in Patients with High-Risk pT1 Colorectal Cancer?Journal of gastrointestinal cancer · 2025Article
- Surveillance and Surgical Salvage Treatment for Endoscopically Removed T1 Colorectal Cancers.Gut and liver · 2025Review
- Article
- Combined Endoscopy-Laparoscopy Surgery: When and How to Utilize This Tool.Clinics in colon and rectal surgery · 2024Review
- Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection.Clinics in colon and rectal surgery · 2024Review
- Prediction of lymph node metastasis in T1 colorectal cancer based on combination of body composition and vascular invasion.International journal of colorectal disease · 2024Article
- Endoscopic resection alone as a potential treatment method for low-risk deep invasive T1 colorectal cancer.iGIE : innovation, investigation and insights · 2023Article
- Predicting lymph node metastasis in colorectal cancer: An analysis of influencing factors to develop a risk model.World journal of gastrointestinal surgery · 2023Article
- Outcome of Completion Surgery after Endoscopic Submucosal Dissection in Early-Stage Colorectal Cancer Patients.Cancers · 2023Article
- Review
- Limited wedge resection for T1 colon cancer (LIMERIC-II trial) - rationale and study protocol of a prospective multicenter clinical trial.BMC gastroenterology · 2023Article
- Effects of prior endoscopic resection on recurrence in patients with T1 colorectal cancer who underwent radical surgery.International journal of colorectal disease · 2023Article
- Colonoscopy-Assisted Laparoscopic Wedge Resection for the Treatment of Suspected T1 Colon Cancer.Annals of surgical oncology · 2023Article
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIt is difficult to predict the presence of histological risk factors for lymph node metastasis (LNM) before endoscopic treatment of T1 colorectal cancer (CRC). Therefore, endoscopic therapy is propagated to obtain adequate histological staging. We examined whether secondary surgery following endoscopic resection of high-risk T1 CRC does not have a negative effect on patients' outcomes compared with primary surgery.
designPatients with T1 CRC with one or more histological risk factors for LNM (high risk) and treated with primary or secondary surgery between 2000 and 2014 in 13 hospitals were identified in the Netherlands Cancer Registry. Additional data were collected from hospital records, endoscopy, radiology and pathology reports. A propensity score analysis was performed using inverse probability weighting (IPW) to correct for confounding by indication.
results602 patients were eligible for analysis (263 primary; 339 secondary surgery). Overall, 34 recurrences were observed (5.6%). After adjusting with IPW, no differences were observed between primary and secondary surgery for the presence of LNM (OR 0.97; 95% CI 0.49 to 1.93; p=0.940) and recurrence during follow-up (HR 0.97; 95% CI 0.41 to 2.34; p=0.954). Further adjusting for lymphovascular invasion, depth of invasion and number of retrieved lymph nodes did not alter this outcome.
conclusionsOur data do not support an increased risk of LNM or recurrence after secondary surgery compared with primary surgery. Therefore, an attempt for an en-bloc resection of a possible T1 CRC without evident signs of deep invasion seems justified in order to prevent surgery of low-risk T1 CRC in a significant proportion of patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.