pT1 Colorectal Cancer Detected in a Colorectal Cancer Mass Screening Program: Treatment and Factors Associated with Residual and Extraluminal Disease
| Autor: | Carmen Domínguez Ferreiro, Coral Tejido Sandoval, Elena Rodríguez-Camacho, Joaquín Cubiella, Cristina Sánchez Gómez, Raquel Almazán, Isabel Peña-Rey Lorenzo, Natalia de Vicente Bielza, Juana Fontenla Rodiles, Antía González, Raquel Zubizarreta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty pT1 Colorectal cancer colorectal cancer Disease PT1 Colorectal Cancer lcsh:RC254-282 Article 03 medical and health sciences 0302 clinical medicine endoscopic resection Submucosa Program treatment medicine Endoscopic resection Mass screening overtreatment business.industry screening Histology medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens digestive system diseases Surgery body regions side effects medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business |
| Zdroj: | Cancers, Vol 12, Iss 2530, p 2530 (2020) Cancers Volume 12 Issue 9 |
| ISSN: | 2072-6694 |
| Popis: | The aim of this study is to describe the treatment of pT1 colorectal cancer (CRC) in a mass screening program, the surgery-related complications and the factors associated with residual disease after endoscopic resection and extraluminal disease after surgery. We included in this retrospective analysis all the pT1 CRC detected in the Galician CRC screening program between May 2013 and June 2019. We determined which variables were independently associated with the outcomes of the study through a multivariable logistic regression analysis. We included 370&ndash 354 pT1 N0(X), 16 pT1N1- out of the 971 CRC detected 277 (74.9%) were resected endoscopically and 162 (43.8%) were not referred to surgery. There were surgical complications in 30.7% and 16.3% of the patients during hospitalization and after discharge. Residual disease was detected in 12 (4.3%) after endoscopic resection and extraluminal disease in 18 (8.6%) patients after surgery. The variables independently associated with initial endoscopic resection were a pedunculated morphology (OR 33.1, 95% CI 4.3&ndash 254), a diameter &ge 20 mm (OR 3.94, 95% CI 1.39&ndash 11.18) and a Site&ndash Morphology&ndash Size&ndash Access score < 9 (OR 428, 95% CI 42&ndash 4263). The variables related with surgery rescue were a piecemeal resection (OR 4.48, 95% CI 1.48&ndash 13.6), an infiltrated/nonevaluable resection border (OR 7.44, 95% CI 2.12&ndash 26.0), a non-well-differentiated histology (OR 4.76, 95% CI 1.07&ndash 20.0), vascular infiltration (OR 8.24, 95% CI 2.72&ndash 25.0) and a Haggitt 4 infiltration of the submucosa (OR 5.68, 95% CI 2.62&ndash 12.3). Residual disease after endoscopic resection was associated with an infiltrated/nonevaluable resection border (OR 34.9, 95% CI 4.08&ndash 298), a non-well-differentiated histology (OR 6.67, 95% CI 1.05&ndash 50.0), and the vascular infiltration of the submucosa (OR 7.61, 95% CI 1.55&ndash 37.4). The variables related with extraluminal disease after surgical resection were no endoscopic resection (OR 4.34, 95% CI 1.26&ndash 14.28), a non-well-differentiated histology (OR 4.35, 95% CI 1.39&ndash 14.29) and the lymphatic infiltration of the submucosa (OR 4.8, 95% CI 1.32&ndash 17.8). In a CRC screening program, although most of pT1 CRC are candidates for endoscopic treatment, surgery is a safe procedure. We have defined some easy to evaluate variables that can be used in the decision-making process. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|