Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
J Gastroenterol. 2011 Feb;46(2):203-11. doi: 10.1007/s00535-010-0341-2. Epub 2010 Dec 9.
Because the rate of recurrence after curative resection for T1 colorectal cancer is low, the characteristics of recurrence remain obscure. This multicenter study attempted to clarify the characteristics of recurrence after curative resection for T1 colorectal cancer.
We analyzed the associations between recurrence and various clinicopathological features in 798 patients who had undergone curative resection alone for T1 colorectal cancer at 14 hospitals between 1991 and 1996.
The rate of lymph node metastasis (LNM) in patients with T1 colorectal cancer was 10.5% (84/798), and 18 (2.3%) of the 798 patients developed recurrence during the median follow-up of 7.8 years. The recurrence rates in patients with colon cancer with and without LNM were 3.6 and 1.3%, respectively (p = 0.19). These rates in patients with cancer of the rectum were 25.0 and 1.1% (p < 0.0001). Among various parameters, histological grade (p < 0.0001), location (p = 0.025), LNM (p < 0.0001), and venous invasion (p = 0.0013) were risk factors for recurrence. Among them, LNM (p = 0.0008) and histological grade (p = 0.041) were independent risk factors for recurrence after curative resection for T1 colorectal cancer. Time to recurrence was more likely to be shorter for patients with, than without nodal involvement. In patients with an unfavorable histological grade, all recurrences developed within 1 year.
The recurrence rate after curative resection for node-negative T1 colorectal cancer was very low. The effectiveness of surveillance to detect recurrence after curative resection for T1 colorectal cancer should be validated in further studies.
由于 T1 结直肠癌根治性切除术后的复发率较低，其复发特点仍不明确。本多中心研究旨在阐明 T1 结直肠癌根治性切除术后的复发特点。
我们分析了 1991 年至 1996 年间 14 家医院收治的 798 例 T1 结直肠癌根治性切除术后患者的复发与各种临床病理特征之间的关系。
T1 结直肠癌患者的淋巴结转移（LNM）率为 10.5%（84/798），798 例患者中有 18 例（2.3%）在中位随访 7.8 年内复发。有 LNM 和无 LNM 的结肠癌患者的复发率分别为 3.6%和 1.3%（p=0.19）。直肠癌患者的复发率分别为 25.0%和 1.1%（p<0.0001）。在各种参数中，组织学分级（p<0.0001）、部位（p=0.025）、LNM（p<0.0001）和静脉侵犯（p=0.0013）是复发的危险因素。其中，LNM（p=0.0008）和组织学分级（p=0.041）是 T1 结直肠癌根治性切除术后复发的独立危险因素。有淋巴结受累的患者复发时间更短。组织学分级较差的患者，所有复发均发生在 1 年内。
T1 结直肠癌根治性切除术后无淋巴结转移患者的复发率非常低。进一步研究应验证 T1 结直肠癌根治性切除术后监测复发的有效性。
