ArticleBJS open2024
Risk of recurrence in high-risk T1 colon cancer following endoscopic and surgical resection: registry-based cohort study.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Predictive factors for isolated pulmonary metastasis in pathological T1 colorectal cancer following curative resection with lymph node dissection: a multicenter study.Surgery today · 2026Article
- Long-term outcomes of pT1 rectal cancer after transanal endoscopic surgery: again, a word of caution on high local recurrence - a cohort study.International journal of colorectal disease · 2026Observational
- Salvage Surgery After Non-Curative Endoscopic Submucosal Dissection for Early Colorectal Cancer: A Comprehensive Review.Journal of clinical medicine · 2025Review
- Retrospective accuracy analysis of major guidelines and factors for lymph node metastasis of pT1 colorectal cancer.Endoscopy international open · 2025Article
- Emerging endoscopic resection strategies for organ preservation in early colorectal cancer.Annals of gastroenterologyReview
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Authors and funding
5 authors.
Funding
Abstract
backgroundEndoscopic resection of T1 colon cancer (CC) is currently limited by guidelines related to risk of lymph node metastases. However, clinical outcome following endoscopic and surgical resection is poorly investigated.
methodA retrospective multicentre national cohort study was conducted on prospectively collected data from the Swedish colorectal cancer registry on all non-pedunculated T1 CC patients undergoing surgical and endoscopic resection between 2009 and 2021. Patients were categorized on the basis of deep submucosal invasion (Sm2-3), lymphovascular invasion (LVI), poor tumour differentiation, and R1/Rx into low- and high-risk cases. The primary outcomes of interest were recurrence rates and disease-free interval (DFI, defined as time from treatment to date of recurrence) according to resection methods and risk factors (sex, age at diagnosis, histologic grade, LVI, perineural invasion, mucinous subtype, submucosal invasion, tumour location, resection margin and nodal positivity in the surgical group).
resultsIn total, 1805 patients undergoing endoscopic (488) and surgical (1317) resection with 60.0 months median follow-up were included. Recurrence occurred in 18 (3.7%) endoscopically and 48 (3.6%) surgically resected patients. Adjuvant treatment was administered in 7.4% and 0.2% of the cases respectively in the surgical and endoscopically treated patients. Five-year DFI was 95.6% after endoscopic and 96.2% after surgical resection, with no significant difference when adjusting for confounding factors (HR 1.03, 95% c.i. 0.56 to 1.91, P = 0.920). There were no statistically significant differences in recurrence comparing endoscopic (1.7%) versus surgical (3.6%) low-risk and endoscopic (5.4%) versus surgical (3.8%) high-risk cases. LVI was the only significant risk factor for recurrence in multivariate Cox regression (HR 3.73, 95% c.i. 1.76 to 7.92, P < 0.001).
conclusionsThis study shows no difference in recurrence after endoscopic and surgical resection in high-risk T1 CC. Although it was not possible to match groups according to treatment, the multivariate analysis showed that lymphovascular invasion was the only independent risk factor for recurrence.
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