Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Korean J Intern Med. 2024 Jul;39(4):563-576. doi: 10.3904/kjim.2023.487. Epub 2024 May 14.
The detection of early colorectal cancer (CRC) is increasing through the implementation of screening programs. This increased detection enhances the likelihood of minimally invasive surgery and significantly lowers the risk of recurrence, thereby improving patient survival and reducing mortality rates. T1 CRC, the earliest stage, is treated endoscopically in cases with a low risk of lymph node metastasis (LNM). The advantages of endoscopic treatment compared with surgery include minimal invasiveness and limited tissue disruption, which reduce morbidity and mortality, preserve bowel function to avoid colectomy, accelerate recovery, and improve cost-effectiveness. However, T1 CRC has a risk of LNM. Thus, selection of the appropriate treatment between endoscopic treatment and surgery, while avoiding overtreatment, is challenging considering the potential for complete resection, LNM, and recurrence risk.
早期结直肠癌（CRC）的检测通过实施筛查计划正在增加。这种检测的增加提高了微创手术的可能性，并显著降低了复发的风险，从而提高了患者的生存率并降低了死亡率。T1 CRC 是最早的阶段，在淋巴结转移（LNM）风险低的情况下通过内镜进行治疗。与手术相比，内镜治疗的优势包括微创和组织破坏有限，从而降低发病率和死亡率，保留肠功能以避免结肠切除术，加速恢复，并提高成本效益。然而，T1 CRC 有 LNM 的风险。因此，考虑到完全切除、LNM 和复发风险的可能性，在避免过度治疗的情况下，在内镜治疗和手术之间选择合适的治疗方法具有挑战性。
