ArticleSurgical endoscopy2024
Long-term outcomes of endoscopic or surgical resection in T1 colorectal cancer patients: a retrospective cohort study.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 3 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 3 syntheses or guidelines pooled it, 3 citations in OpenAlex.
- Endoscopic resection versus surgery for T1 rectal cancer: A systematic review and meta-analysis of oncologic and safety outcomes.Surgical endoscopy · 2026Pooled it
- The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0.Annals of coloproctology · 2026Guideline
- Long-term outcomes of additional surgery versus surveillance-only clinical decision for early colorectal cancer patients after non-curative endoscopic resection: a meta-analysis.BMC gastroenterology · 2024Pooled it
- Clinicopathological features and risk stratification for lymph node metastasis in early-stage colorectal cancer (from intramucosal carcinoma to SM2): a large-scale retrospective study based on a Chinese population.Virchows Archiv : an international journal of pathology · 2026Article
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundThe personalized treatments of T1 colorectal cancer (CRC) remains controversial. We compared the long-term outcomes of T1 CRC patients after endoscopic resection (ER) and surgery, and evaluated the risk factors for the long-term prognosis.
methodsT1 CRCs after resection at the Cancer Hospital, Chines Academy of Medical Sciences from June 2011 to November 2021 were reviewed. High-risk factors included positive resection margin, poor differentiation, deep submucosal invasion (DSI ≥ 1000 μm), lymphovascular invasion and intermediate/high tumor budding. Comparative analyses were conducted based on three treatment methods: follow-up after ER (Group A), additional surgery after ER (Group B) and initial surgery (Group C). The primary endpoints included recurrence-free survival (RFS) and overall survival (OS). Cox proportional hazard regression models were constructed to identify risk factors for RFS and OS.
resultsA total of 528 patients were enrolled (173 patients in Group A, 102 patients in Group B, 253 patients in Group C). The 3-year RFS, 5-year RFS, 3-year OS, and 5-year OS rates were 96.7%, 94.7%, 99.1%, and 97.8%, respectively. In the absence of other high-risk factors, RFS (P = 0.321) and OS (P = 0.155) of patients with DSI after ER were not inferior to those after surgery. Multivariate analyses identified sex (HR 0.379; 95% CI 0.160-0.894), Charlson comorbidities index (CCI) (HR 3.330; 95% CI 1.571-7.062), margin (HR 8.212; 95% CI 2.325-29.006), and budding (HR 3.794; 95% CI 1.686-8.541) as independent predictive factors of RFS, and identified CCI (HR 10.266; 95% CI 2.856-36.899) as an independent predictive factor of OS.
conclusionThe long-term outcomes of ER are comparable to those of surgery in T1 CRC patients with DSI when other high-risk factors are negative. Resection margin, tumor budding, sex, and CCI may be the most important long-term prognostic factors for T1 CRC patients.
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