Impact of ≥ 0.1-mm free resection margins on local intramural residual cancer after local excision of T1 colorectal cancer.

Autor: Gijsbers KM; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, The Netherlands., van der Schee L; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., van Veen T; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., van Berkel AM; Department of Gastroenterology & Hepatology, Noordwest Hospital, Alkmaar, The Netherlands., Boersma F; Department of Gastroenterology & Hepatology, Gelre Hospital, Apeldoorn, The Netherlands., Bronkhorst CM; Pathology-DNA, Jeroen Bosch Hospital, Den Bosch, The Netherlands., Didden PD; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Haasnoot KJC; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Jonker AM; Department of Pathology, Gelre Hospital, Apeldoorn, The Netherlands., Kessels K; Department of Gastroenterology & Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands., Knijn N; Pathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands., van Lijnschoten I; Department of Pathology, PAMM, Eindhoven, The Netherlands., Mijnals C; Department of Pathology, Amphia Hospital, Breda, The Netherlands., Milne AN; Pathology-DNA, St. Antonius Hospital, Nieuwegein, The Netherlands., Moll FCP; Department of Pathology, Isala Clinics, Zwolle, The Netherlands., Schrauwen RWM; Department of Gastroenterology & Hepatology, Bernhoven, Uden, The Netherlands., Schreuder RM; Department of Gastroenterology & Hepatology, Catharina Hospital, Eindhoven, The Netherlands., Seerden TJ; Department of Gastroenterology & Hepatology, Amphia Hospital, Breda, The Netherlands., Spanier MBWM; Department of Gastroenterology & Hepatology, Rijnstate Hospital, Arnhem, The Netherlands., Terhaar Sive Droste JS; Department of Gastroenterology & Hepatology, Jeroen Bosch Hospital, Den Bosch, The Netherlands., Witteveen E; Department of Pathology, Noordwest Hospital, Alkmaar, The Netherlands., de Vos Tot Nederveen Cappel WH; Department of Gastroenterology & Hepatology, Isala Clinics, Zwolle, The Netherlands., Vleggaar FP; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands., Laclé MM; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands., Ter Borg F; Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, The Netherlands., Moons LMG; Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Endoscopy international open [Endosc Int Open] 2022 Apr 14; Vol. 10 (4), pp. E282-E290. Date of Electronic Publication: 2022 Apr 14 (Print Publication: 2022).
DOI: 10.1055/a-1736-6960
Abstrakt: Background and study aims  A free resection margin (FRM) > 1 mm after local excision of a T1 colorectal cancer (CRC) is known to be associated with a low risk of local intramural residual cancer (LIRC). The risk is unclear, however, for FRMs between 0.1 to 1 mm. This study evaluated the risk of LIRC after local excision of T1 CRC with FRMs between 0.1 and 1 mm in the absence of lymphovascular invasion (LVI), poor differentiation and high-grade tumor budding (Bd2-3). Patients and methods  Data from all consecutive patients with local excision of T1 CRC between 2014 and 2017 were collected from 11 hospitals. Patients with a FRM ≥ 0.1 mm without LVI and poor differentiation were included. The main outcome was risk of LIRC (composite of residual cancer in the local excision scar in adjuvant resection specimens or local recurrence during follow-up). Tumor budding was also assessed for cases with a FRM between 0.1 and 1mm. Results  A total of 171 patients with a FRM between 0.1 and 1 mm and 351 patients with a FRM > 1 mm were included. LIRC occurred in five patients (2.9 %; 95 % confidence interval [CI] 1.0-6.7 %) and two patients (0.6 %; 95 % CI 0.1-2.1 %), respectively. Assessment of tumor budding showed Bd2-3 in 80 % of cases with LIRC and in 16 % of control cases. Accordingly, in patients with a FRM between 0.1 and 1 mm without Bd2-3, LIRC was detected in one patient (0.8%; 95 % CI 0.1-4.4 %). Conclusions  In this study, risks of LIRC were comparable for FRMs between 0.1 and 1 mm and > 1 mm in the absence of other histological risk factors.
Competing Interests: Competing interests Dr. Moons is consultant for Boston Scientific.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze: MEDLINE
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