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Characteristics of minute T1 colorectal cancer in relevance to pathology and treatment

Annals of Surgical Treatment and Research 2020년 98권 4호 p.199 ~ 205
 ( Park Sin-Hye ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer

 ( Oh Seon-Ok ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
박성실 ( Park Sung-Sil ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
 ( Roh Seung-Jae ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
한경수 ( Han Kyung-Su ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
김번 ( Kim Bun ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
홍창원 ( Hong Chang-Won ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
김병창 ( Kim Byung-Chang ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
손대경 ( Sohn Dae-Kyung ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer
장희진 ( Chang Hee-Jin ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer

Abstract


Purpose: Minute T1 colorectal cancer (CRC) lesions (≤5 mm) are rare; however, little is known about their characteristics and aggressiveness. In this study, we evaluated the characteristics of minute T1 CRC in relevance to pathology and treatment.

Methods: This retrospective study included 849 patients with T1 CRC endoscopically or surgically treated between January 2001 and December 2016. The patients were stratified into 4 groups according to tumor size; minute group (≤5 mm), small group (6?10 mm), medium group (11?20 mm), and large group (≥21 mm). Clinicopathological variables were evaluated with respect to tumor size.

Results: The incidence of the minute T1 CRC was 2.4% (20 of 849). Minute T1 CRC was significantly associated with flat type (minute, 25%; small, 12.6%; medium, 8.8%; large, 12.6%; P = 0.016), right-sided cancer (30%, 15.4%, 15.4%, 15.1%, P = 0.002) and the absence of background adenoma (BGA) (50%, 40.7%, 32.8%, 18.1%, P < 0.001). In patients who underwent surgery, lymph node metastasis (LNM) was significantly higher in the minute group (36.4%, 15.9%, 15.7%, 9.2%, P = 0.029).

Conclusion: Minute T1 CRC is significantly associated with flat type, right-sided cancers, as well as with the absence of BGA and LNM. These results suggested the minute T1 CRC lesions are often aggressive and are likely to be missed during colonoscopy.

키워드

Colonoscopy; Colorectal neoplasm; Size
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